舌下神经管区的临床应用解剖学研究
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摘要
第一部分舌下神经管及其毗邻骨性结构的显微解剖特征
目的:研究舌下神经管及其毗邻骨性结构的形态、大小,相互关系及其骨性解剖标志,为舌下神经管区的手术入路研究提供解剖学依据。方法:取成人颅底干性骨标本25个和寰椎干性骨标本15个,观察舌下神经管(hypoglossalcanal,HC)及其周围骨性结构的形态及相互关系,测量相关骨性结构的大小和间距;对双侧距离的差别进行统计学分析。随机选取3例成人湿性头颈标行轴位、冠状位薄层CT扫描后薄层断层切片(横断面、矢状面、冠状面各1例)观察;结果:从颅底看,枕骨髁的长轴与枕骨大孔的外缘前半平行;HC藏于枕髁与颈静脉结节之间,居于颈静脉孔内下前方,长轴与矢状面的夹角:左为42.2士3.4(34.5～47)°,右为42.5士3.5(34～47.8)°;髁管出现率为64%,HC与髁管形成一夹角约48°,髁管后口距枕髁后极左4.8±1.0(3.5～7)mm,右为3.9±1.1(2.1～6)mm。颈静脉结节上表面到达舌下神经管上壁的距离约5mm。颈静脉孔至HC内口约9mm。枕髁后缘到达HC内口、外口的距离左13.08士2.3mm,16.8士2.4 mm;右13.24士2.3 mm,17.1士2.5 mm。寰椎横突长度左右分别为左9.27±1.6(6.5～12.5)mm;右9.29±1.8(6.1～12.3)mm;枕骨颈突位于乳突和枕髁之中间,茎突的后内侧,是颈静脉孔后缘的标志。横窦和乙状窦的转折点即为前星点,枕外隆突到颧弓根连线为横窦标志。星点是容易识别的的重要解剖标志,但星点与横窦的关系不恒定,变异大,15侧(30.0%)星点位于横窦沟内,17侧(34.0%)位于横窦沟上,18侧(36.0%)位于横窦沟下。结论:舌下神经管位置深在,暴露困难,枕髁、颈静脉结节、寰椎横突是侧方暴露舌下神经管区域的主要骨性障碍;星点、乳突、茎突、颈静脉结节、枕髁是HC区域外侧方入路的主要骨性标志;枕髁、颈静脉结节是远外侧经髁入路处理Ⅸ,Ⅹ,Ⅺ和Ⅻ颅神经及达中下斜坡脑干腹侧病变最重要的骨性标志和目标。
第二部分舌下神经管及其毗邻结构的显微外科解剖学特征
目的:研究舌下神经管区域(hypoglossal canal aera,HGCA)手术入路显微解剖关系,为舌下神经管区的手术入路研究提供显微外科解剖学基础。方法:取成人尸体头颈标本8具,分别从后外侧和前外侧方向暴露颅颈交界区的颅外相关肌肉、神经血管,最后切除寰椎横突和枕鳞,磨除枕髁和颈静脉结节研究暴露舌下神经管管部及其内外口,研究其内容物及其周围的神经血管显微解剖关系。结果:1根据寰椎横突可以将颅颈交界区的侧方分为前外方的咽旁间隙和后外方的枕下区,位于前者内的主要是进出颅底的颈内外动静脉大血管和颅外段后组颅神经等重要神经和血管,位于后者内的主要为枕下肌群和椎动脉枕下段和椎静脉丛。在咽旁间隙内,茎突隔是重要解剖标志,它将咽旁间隙分为茎突前间隙和茎突后间隙,舌下神经、舌咽神经、副神经及迷走神经行于茎突后间隙内的颈内动脉与颈内静脉之间。枕下三角和颈2神经的腹侧支是识别椎动脉的重要标志,头外侧直肌是识别颈静脉孔的重要标记。2舌下神经的走形及舌下神经管内容物舌下神经分三段:脑池段、舌下神经管管内段、颅外段。上内侧界茎突舌骨肌的下缘,下行的舌下神经构成外侧界和横跨的舌下神经上根构成底边(下界)所围成的颈前“舌下神经”三角结构恒定,且易于识别。HC管壁由骨密质组成,在磨除骨质时,从骨松质到出现骨密质即表示到达了舌下神经管壁,HC管内由后向前有静脉丛、舌下神经和咽升动脉的分支,其中主要为静脉丛,静脉丛贯穿舌下神经管全程并包绕舌下神经鞘。结论:寰椎横突既是定位枕下区重要结构的重要解剖标志,又是从后外侧到达舌下神经管外口的主要障碍;茎突是咽旁间隙外科解剖的钥匙。利用舌下神经在颅外和颅内行走特点,可以安全地找到舌下神经;HC管壁是保护舌下神经免受损伤的“第一道预警装置”;舌下神经管静脉丛是舌下神经管的主要内容物,也是保护舌下神经免受损伤的“第二道预警装置”;舌下神经鞘膜是保护舌下神经免受损伤的“最后屏障”。颈前“舌下神经三角”是寻找颅外段舌下神经重要的解剖标志,掌握其解剖特征有利于经颈前侧方入路时鉴别神经,准确定位舌下神经并逆行探至舌下神经管外口。
第三部分舌下神经管及其毗邻结构的三维CT重建及数字化模拟相关手术入路的定性定量分析
目的:构建颅颈交界区(caniocervical junction region,CCJR)三维可视化模型,初步探索该模型的功能,阐明HGCA各解剖结构的分布规律和空间位置关系,数字化模拟手术入路定性定量分析,为HGCA外科手术治疗方案的选择提供数字化三维解剖学依据。方法:随机抽取经64排螺旋CT检查(含C4-鞍背并增强,扫描层厚0.3 mm)的正常成人标本10例。将CT数据输入电脑后,利用Mimics软件进行三维重建处理,构建舌下神经管及其毗邻结构,构建包含颅颈交接区的动脉、静脉系统,对舌下神经管、入路相关毗邻结构进行解剖学观察与测量,并与尸体解剖结果进行对比分析,模拟手术入路数字化分析切割主要的骨性障碍视角扩大范围。结果:建立了CCJR三维可视化模型,通过模型二维与三维空间的观察与测量,结果与尸体解剖层次、重要角度与距离结果基本一致。结论:可以通过Mimics软件重建的CCJR的可视化模型,此模型在结构毗邻关系的展示、直观地量化定位和方便的结构间测量,模拟手术数字化定量分析等功能上具有优势;目前的模型尚不能满足一些微细解剖结构的研究,尚不能完全满足舌下神经管区手术入路的真实模拟训练,有待进一步改进和完善。
PartⅠMicrosurgical anatomy of the osseous hypoglossal canal and its osseous adjacent structures.
Purpose:To study the morphology,dimension and relation of the osseous hypoglossal canal(HC) and its adjacent bony structures for further study of surgical approach in this area.Methods:The osseous hypoglossal canal(HC)and its adjacent osseous structures were observed and measured anatomically,and bilateral differences in distance were statistically analyzed on 25 dry specimens of adult skull base bone and 15 dry specimens of atlas.Three wet specimens of randomly selected adult standard head and neck were made axis line,and coronal CT scanning before they were seperated by thin-layer slices(cross-sectional,1case; sagittal,1;coronal plane,1).Results:In the view of the base skull,the long axis of the occipital condyle and the outer edge of the foramen magnum parallel to the first half;hypoglossal canal was hidden in between occipital condyle and anterior, medial and inferior to the jugular foramen.The angle formed by HC and sagittal plane in left and right side was 42.2±3.4(34.5～47),42.5±3.5(34～47.8)degrees respectively.The angle formed by HC and condylar canal which was present 64% was about 48 degrees.Occipital condyles from the posterior pole to deutostoma of condylar canal left 4.8±1.0(3.5～7) mm,right 3.9±1.1(2.1～6) mm.The distance between jugular tubercle and the surface of nodules on the hypoglossal canal wall was about 5mm.The distance between jugular foramen and hypoglossal canal endostoma was about 9mm.The distance between the posterior edge of occipital condyle and intracranial orifice or extracranial orifice of hypoglossal canal was 13.08±2.3mm(left),16.8±2.4 mm;13.24±2.3 mm,17.1±2.5 mm(right). Transverse process of atlas were left around the length of 9.27±1.6(6.5～12.5) mm;right 9.29±1.8(6.1～12.3) mm.Occipital cervical process is located in between mastoid and occipital condyle,and the posterior medial of styloid process,and it is the landmark of of posterior edge the jugular foramen.Transverse sinus and sigmoid sinus is a turning point in the former asterion,and the occipital protuberance to the zygomatic arch outside the root symbol was connected to transverse sinus.Asterion is the importance of readily identifiable anatomical landmark,but the relationship between the transverse sinus and it is not constant, and exists variation,15 lateral(30.0%) sites are located in transverse sinus,17 sides(34.0%) upper the transverse sinus groove,18 sides(36.0%) under the groove of the transverse sinus.Conclusion:Hypoglossal canal is located deeply and it is very difficult to expose it.Occipital condyle,jugular tubercle,transverse process of atlas are the main obstacles in the access to the hypoglossal canal region; asterion,mastoid,styloid process,jugular tubercle,occipital condyle are the main osseous signs of lateral approach to the hypoglossal canal region;occipital condyle, jugular tubercle are the most important osseous landmarks and objectives by far lateral approach to deal with condylar,cranial nervesⅨ,Ⅹ,ⅪandⅫand the lesions of ventral brain stem in the middle and lower clivus.
Part 2 Microsurgical anatomy features of the hypoglossal canal and its adjacent structures the microsurgical anatomy features
Purpose:To investigate the Microsurgical anatomy features of the hypoglossal canal(HC) and its adjacent structures for the further study of surgical approach in this area.Methods:The microsurgical anatomy of the extracranial muscles,nevres and vessels in the caniocervical junction region(CCJR) were investigated in 8 cadaveric head-neck specimens posterolaterally and anterolaterally, respectively.Then the transverse process of the atlas(TPA),occipital squama, occipital condyle and jugular tubercle were removed to observe the content of HC and the relationship of nerves and vessels with in HC and between HC and its adjacent structures.Results:1.caniocervical junction region(CCJR) can be divided into the lateral side of the former parapharyngeal space and hind suboccipital area by transverse process of the atlas,the former is the main access to the skull base arteriovenous large blood vessels(ICA,ECA,IJV,EJV) and cranial extracellular latter cranial nerve and so on,the latter is mainly the suboccipital suboccipital muscles and the vertebral artery and vertebral venous plexus.In the parapharyngeal space,the stylid diaphragm is an important anatomical landmark and the parapharyngeal space is subdivided into prestyloid and poststyloid compartments by the stylid diaphragm.There were internal carotid artery,internal jugular vein and theⅨ、Ⅹ、Ⅺ、Ⅻcranial nerves in the retroparapharyngeal space.The suboccipital triangle and ventral branch of C2 nerve were the important marks,and rectus capitis lateralis was the important symbol to identify the jugular foramen.2.The hypoglossal nerve(HN) path and contents of HC The HN is divided into three main parts:cisternal,intracanalicular and extracranial.It is the newly described 'hypoglossal' triangle in the anterior neck that is bordered by the descending hypoglossus laterally,transverse hypoglossus inferiorly and inferior border of the stylohyoid muscle superiorly.The structure is constant,and easily identifiable.HC wall is made up from compact bone.In the mill the emergence of the compact bone from cancellous bone that wall mean reaching the HC.From the former direction to the rear there are the venous plexus mainly,hypoglossal nerve, ascending pharyngeal artery through the hypoglossal canal and hypoglossal nerve is envelopped by the whole hypoglossal nerve sheath.Conclusion:TPA can serve as an important landmark in identifying important structures in suboccipital area, however it is also a big handrance which blocks the access to extracranial orifice of HC posterolaterally.Styloid is the key to anatomy of parapharyngeal space.Hypoglossal nerve can be identified safely according to its features of either extracranial or intracranial part.HC wall is the first forecasting set preserving hypoglossal nerve.The venous plexus of HC is a landmark to identify HC and aslo is the second forecasting set preserving hypoglossal nerve.Hypoglossal nerve sheath is the final barrier to protect hypoglossal nerve against injury.'hypoglossal' triangle in the anterior neck is an important anatomical landmark in order to find extracranial hypoglossal nerve,master of whose anatomical characteristics is conducive to the anterior lateral approach in the identification of nerves,accurate positioning and retrograde exploration from hypoglossal hypoglossal nerve to extracranial orifice of HC.
Part 3 3-D CT reconstruction of Hypoglossal canal and its adjacent structures and digital simulation for surgical approach-related qualitative and quantitative analysis
Objective:Construction of 3D visualization of the CCJR model,preliminary exploration of the function of the model,Clarify the anatomy of the HGCA structure and the distribution of spatial relations,for the HGCA clinical treatment of surgery figures provided by the choice of three dimensional anatomical basis.Methods:Specimens of 10 cases of normal adults were selected randomly by the 64-slice spiral CT examination(including C4-dorsum sellae and CT enhance,the scanning slice thickness 0.3 mm).CT data were entered into the computer using the materialise interactive medical image control system (Mimics) software to deal with three-dimensional reconstruction of hypoglossal canal and adjacent structures,construction of the the CCJR that contains craniocervical arteries,venous system.The hypoglossal canal and the approach-related adjacent structures were made anatomical observation and measurement,and comparative analysis to autopsy results,the quantitative analysis of simulation for surgical approach to cut the main bone obstacles for expanding the scope of perspective.Results:Three-dimensional visualization model of CCJR was set up.Through observation and measurement of two-dimensional and three-dimensional space for models,the level of results and autopsy was illustrated with consistent results including anatomical layer,the important point of view and distance.Conclusion:The CCJR virtual human data can be reconstructed by Mimics software.This model relations in the structure adjacent to the display, intuitive and easy to quantify positioning measurement of the structure has advantage s such as functional;But the current virtual human data collection and the establishment of the visualization model can not meet the research of some fine anatomical struc ture,still can not be used for the true simulation training of the surgical approach,waiting to be continuously improved and developed.
目的:研究舌下神经管及其毗邻骨性结构的形态、大小,相互关系及其骨性解剖标志,为舌下神经管区的手术入路研究提供解剖学依据。方法:取成人颅底干性骨标本25个和寰椎干性骨标本15个,观察舌下神经管(hypoglossalcanal,HC)及其周围骨性结构的形态及相互关系,测量相关骨性结构的大小和间距;对双侧距离的差别进行统计学分析。随机选取3例成人湿性头颈标行轴位、冠状位薄层CT扫描后薄层断层切片(横断面、矢状面、冠状面各1例)观察;结果:从颅底看,枕骨髁的长轴与枕骨大孔的外缘前半平行;HC藏于枕髁与颈静脉结节之间,居于颈静脉孔内下前方,长轴与矢状面的夹角:左为42.2士3.4(34.5～47)°,右为42.5士3.5(34～47.8)°;髁管出现率为64%,HC与髁管形成一夹角约48°,髁管后口距枕髁后极左4.8±1.0(3.5～7)mm,右为3.9±1.1(2.1～6)mm。颈静脉结节上表面到达舌下神经管上壁的距离约5mm。颈静脉孔至HC内口约9mm。枕髁后缘到达HC内口、外口的距离左13.08士2.3mm,16.8士2.4 mm;右13.24士2.3 mm,17.1士2.5 mm。寰椎横突长度左右分别为左9.27±1.6(6.5～12.5)mm;右9.29±1.8(6.1～12.3)mm;枕骨颈突位于乳突和枕髁之中间,茎突的后内侧,是颈静脉孔后缘的标志。横窦和乙状窦的转折点即为前星点,枕外隆突到颧弓根连线为横窦标志。星点是容易识别的的重要解剖标志,但星点与横窦的关系不恒定,变异大,15侧(30.0%)星点位于横窦沟内,17侧(34.0%)位于横窦沟上,18侧(36.0%)位于横窦沟下。结论:舌下神经管位置深在,暴露困难,枕髁、颈静脉结节、寰椎横突是侧方暴露舌下神经管区域的主要骨性障碍;星点、乳突、茎突、颈静脉结节、枕髁是HC区域外侧方入路的主要骨性标志;枕髁、颈静脉结节是远外侧经髁入路处理Ⅸ,Ⅹ,Ⅺ和Ⅻ颅神经及达中下斜坡脑干腹侧病变最重要的骨性标志和目标。
第二部分舌下神经管及其毗邻结构的显微外科解剖学特征
目的:研究舌下神经管区域(hypoglossal canal aera,HGCA)手术入路显微解剖关系,为舌下神经管区的手术入路研究提供显微外科解剖学基础。方法:取成人尸体头颈标本8具,分别从后外侧和前外侧方向暴露颅颈交界区的颅外相关肌肉、神经血管,最后切除寰椎横突和枕鳞,磨除枕髁和颈静脉结节研究暴露舌下神经管管部及其内外口,研究其内容物及其周围的神经血管显微解剖关系。结果:1根据寰椎横突可以将颅颈交界区的侧方分为前外方的咽旁间隙和后外方的枕下区,位于前者内的主要是进出颅底的颈内外动静脉大血管和颅外段后组颅神经等重要神经和血管,位于后者内的主要为枕下肌群和椎动脉枕下段和椎静脉丛。在咽旁间隙内,茎突隔是重要解剖标志,它将咽旁间隙分为茎突前间隙和茎突后间隙,舌下神经、舌咽神经、副神经及迷走神经行于茎突后间隙内的颈内动脉与颈内静脉之间。枕下三角和颈2神经的腹侧支是识别椎动脉的重要标志,头外侧直肌是识别颈静脉孔的重要标记。2舌下神经的走形及舌下神经管内容物舌下神经分三段:脑池段、舌下神经管管内段、颅外段。上内侧界茎突舌骨肌的下缘,下行的舌下神经构成外侧界和横跨的舌下神经上根构成底边(下界)所围成的颈前“舌下神经”三角结构恒定,且易于识别。HC管壁由骨密质组成,在磨除骨质时,从骨松质到出现骨密质即表示到达了舌下神经管壁,HC管内由后向前有静脉丛、舌下神经和咽升动脉的分支,其中主要为静脉丛,静脉丛贯穿舌下神经管全程并包绕舌下神经鞘。结论:寰椎横突既是定位枕下区重要结构的重要解剖标志,又是从后外侧到达舌下神经管外口的主要障碍;茎突是咽旁间隙外科解剖的钥匙。利用舌下神经在颅外和颅内行走特点,可以安全地找到舌下神经;HC管壁是保护舌下神经免受损伤的“第一道预警装置”;舌下神经管静脉丛是舌下神经管的主要内容物,也是保护舌下神经免受损伤的“第二道预警装置”;舌下神经鞘膜是保护舌下神经免受损伤的“最后屏障”。颈前“舌下神经三角”是寻找颅外段舌下神经重要的解剖标志,掌握其解剖特征有利于经颈前侧方入路时鉴别神经,准确定位舌下神经并逆行探至舌下神经管外口。
第三部分舌下神经管及其毗邻结构的三维CT重建及数字化模拟相关手术入路的定性定量分析
目的:构建颅颈交界区(caniocervical junction region,CCJR)三维可视化模型,初步探索该模型的功能,阐明HGCA各解剖结构的分布规律和空间位置关系,数字化模拟手术入路定性定量分析,为HGCA外科手术治疗方案的选择提供数字化三维解剖学依据。方法:随机抽取经64排螺旋CT检查(含C4-鞍背并增强,扫描层厚0.3 mm)的正常成人标本10例。将CT数据输入电脑后,利用Mimics软件进行三维重建处理,构建舌下神经管及其毗邻结构,构建包含颅颈交接区的动脉、静脉系统,对舌下神经管、入路相关毗邻结构进行解剖学观察与测量,并与尸体解剖结果进行对比分析,模拟手术入路数字化分析切割主要的骨性障碍视角扩大范围。结果:建立了CCJR三维可视化模型,通过模型二维与三维空间的观察与测量,结果与尸体解剖层次、重要角度与距离结果基本一致。结论:可以通过Mimics软件重建的CCJR的可视化模型,此模型在结构毗邻关系的展示、直观地量化定位和方便的结构间测量,模拟手术数字化定量分析等功能上具有优势;目前的模型尚不能满足一些微细解剖结构的研究,尚不能完全满足舌下神经管区手术入路的真实模拟训练,有待进一步改进和完善。
PartⅠMicrosurgical anatomy of the osseous hypoglossal canal and its osseous adjacent structures.
Purpose:To study the morphology,dimension and relation of the osseous hypoglossal canal(HC) and its adjacent bony structures for further study of surgical approach in this area.Methods:The osseous hypoglossal canal(HC)and its adjacent osseous structures were observed and measured anatomically,and bilateral differences in distance were statistically analyzed on 25 dry specimens of adult skull base bone and 15 dry specimens of atlas.Three wet specimens of randomly selected adult standard head and neck were made axis line,and coronal CT scanning before they were seperated by thin-layer slices(cross-sectional,1case; sagittal,1;coronal plane,1).Results:In the view of the base skull,the long axis of the occipital condyle and the outer edge of the foramen magnum parallel to the first half;hypoglossal canal was hidden in between occipital condyle and anterior, medial and inferior to the jugular foramen.The angle formed by HC and sagittal plane in left and right side was 42.2±3.4(34.5～47),42.5±3.5(34～47.8)degrees respectively.The angle formed by HC and condylar canal which was present 64% was about 48 degrees.Occipital condyles from the posterior pole to deutostoma of condylar canal left 4.8±1.0(3.5～7) mm,right 3.9±1.1(2.1～6) mm.The distance between jugular tubercle and the surface of nodules on the hypoglossal canal wall was about 5mm.The distance between jugular foramen and hypoglossal canal endostoma was about 9mm.The distance between the posterior edge of occipital condyle and intracranial orifice or extracranial orifice of hypoglossal canal was 13.08±2.3mm(left),16.8±2.4 mm;13.24±2.3 mm,17.1±2.5 mm(right). Transverse process of atlas were left around the length of 9.27±1.6(6.5～12.5) mm;right 9.29±1.8(6.1～12.3) mm.Occipital cervical process is located in between mastoid and occipital condyle,and the posterior medial of styloid process,and it is the landmark of of posterior edge the jugular foramen.Transverse sinus and sigmoid sinus is a turning point in the former asterion,and the occipital protuberance to the zygomatic arch outside the root symbol was connected to transverse sinus.Asterion is the importance of readily identifiable anatomical landmark,but the relationship between the transverse sinus and it is not constant, and exists variation,15 lateral(30.0%) sites are located in transverse sinus,17 sides(34.0%) upper the transverse sinus groove,18 sides(36.0%) under the groove of the transverse sinus.Conclusion:Hypoglossal canal is located deeply and it is very difficult to expose it.Occipital condyle,jugular tubercle,transverse process of atlas are the main obstacles in the access to the hypoglossal canal region; asterion,mastoid,styloid process,jugular tubercle,occipital condyle are the main osseous signs of lateral approach to the hypoglossal canal region;occipital condyle, jugular tubercle are the most important osseous landmarks and objectives by far lateral approach to deal with condylar,cranial nervesⅨ,Ⅹ,ⅪandⅫand the lesions of ventral brain stem in the middle and lower clivus.
Part 2 Microsurgical anatomy features of the hypoglossal canal and its adjacent structures the microsurgical anatomy features
Purpose:To investigate the Microsurgical anatomy features of the hypoglossal canal(HC) and its adjacent structures for the further study of surgical approach in this area.Methods:The microsurgical anatomy of the extracranial muscles,nevres and vessels in the caniocervical junction region(CCJR) were investigated in 8 cadaveric head-neck specimens posterolaterally and anterolaterally, respectively.Then the transverse process of the atlas(TPA),occipital squama, occipital condyle and jugular tubercle were removed to observe the content of HC and the relationship of nerves and vessels with in HC and between HC and its adjacent structures.Results:1.caniocervical junction region(CCJR) can be divided into the lateral side of the former parapharyngeal space and hind suboccipital area by transverse process of the atlas,the former is the main access to the skull base arteriovenous large blood vessels(ICA,ECA,IJV,EJV) and cranial extracellular latter cranial nerve and so on,the latter is mainly the suboccipital suboccipital muscles and the vertebral artery and vertebral venous plexus.In the parapharyngeal space,the stylid diaphragm is an important anatomical landmark and the parapharyngeal space is subdivided into prestyloid and poststyloid compartments by the stylid diaphragm.There were internal carotid artery,internal jugular vein and theⅨ、Ⅹ、Ⅺ、Ⅻcranial nerves in the retroparapharyngeal space.The suboccipital triangle and ventral branch of C2 nerve were the important marks,and rectus capitis lateralis was the important symbol to identify the jugular foramen.2.The hypoglossal nerve(HN) path and contents of HC The HN is divided into three main parts:cisternal,intracanalicular and extracranial.It is the newly described 'hypoglossal' triangle in the anterior neck that is bordered by the descending hypoglossus laterally,transverse hypoglossus inferiorly and inferior border of the stylohyoid muscle superiorly.The structure is constant,and easily identifiable.HC wall is made up from compact bone.In the mill the emergence of the compact bone from cancellous bone that wall mean reaching the HC.From the former direction to the rear there are the venous plexus mainly,hypoglossal nerve, ascending pharyngeal artery through the hypoglossal canal and hypoglossal nerve is envelopped by the whole hypoglossal nerve sheath.Conclusion:TPA can serve as an important landmark in identifying important structures in suboccipital area, however it is also a big handrance which blocks the access to extracranial orifice of HC posterolaterally.Styloid is the key to anatomy of parapharyngeal space.Hypoglossal nerve can be identified safely according to its features of either extracranial or intracranial part.HC wall is the first forecasting set preserving hypoglossal nerve.The venous plexus of HC is a landmark to identify HC and aslo is the second forecasting set preserving hypoglossal nerve.Hypoglossal nerve sheath is the final barrier to protect hypoglossal nerve against injury.'hypoglossal' triangle in the anterior neck is an important anatomical landmark in order to find extracranial hypoglossal nerve,master of whose anatomical characteristics is conducive to the anterior lateral approach in the identification of nerves,accurate positioning and retrograde exploration from hypoglossal hypoglossal nerve to extracranial orifice of HC.
Part 3 3-D CT reconstruction of Hypoglossal canal and its adjacent structures and digital simulation for surgical approach-related qualitative and quantitative analysis
Objective:Construction of 3D visualization of the CCJR model,preliminary exploration of the function of the model,Clarify the anatomy of the HGCA structure and the distribution of spatial relations,for the HGCA clinical treatment of surgery figures provided by the choice of three dimensional anatomical basis.Methods:Specimens of 10 cases of normal adults were selected randomly by the 64-slice spiral CT examination(including C4-dorsum sellae and CT enhance,the scanning slice thickness 0.3 mm).CT data were entered into the computer using the materialise interactive medical image control system (Mimics) software to deal with three-dimensional reconstruction of hypoglossal canal and adjacent structures,construction of the the CCJR that contains craniocervical arteries,venous system.The hypoglossal canal and the approach-related adjacent structures were made anatomical observation and measurement,and comparative analysis to autopsy results,the quantitative analysis of simulation for surgical approach to cut the main bone obstacles for expanding the scope of perspective.Results:Three-dimensional visualization model of CCJR was set up.Through observation and measurement of two-dimensional and three-dimensional space for models,the level of results and autopsy was illustrated with consistent results including anatomical layer,the important point of view and distance.Conclusion:The CCJR virtual human data can be reconstructed by Mimics software.This model relations in the structure adjacent to the display, intuitive and easy to quantify positioning measurement of the structure has advantage s such as functional;But the current virtual human data collection and the establishment of the visualization model can not meet the research of some fine anatomical struc ture,still can not be used for the true simulation training of the surgical approach,waiting to be continuously improved and developed.
引文
[1]Karasu A, Cansever T, Batay F,et al. The microsurgical anatomy of the hypoglossal canal[J]. Surg Radiol Anat. 2009 Jan 14. [Epub ahead of print]. [2]VoVyodic F, Whyte A, Slavotinek J.The hypoglossal canalmormal MR Enhancement pattern[J].AJNR 16:1707-1710, 1995.
[3]Baldauf J, Junghans D, Schroeder HW. Endoscope-assisted microsurgical resection of an intraneural ganglion cyst of the hypoglossal nerve[J]. J Neurosurg. 2006 Jun; 104(6):990-2; author reply 992.
[4]Chennupati SK, Norris R, Dunham B,et al. Osteosarcoma of the skull base: case report and review of literature[J]. Int J Pediatr Otorhinolaryngol. 2008 Jan; 72(1):115-9. Epub 2007 Nov 5.
[5]De Mattel T, Subirana A, Guillaume J.Los tumores de le fosa cerebral posterior voluminoso neurinoma del hipogloso con desarrollo juxtabullbo- protuberan[j]. Operacioncuracion Ars Med 1933; 9:416-9.
[6]Rachinger J, et al.Dumbbell-shaped hypoglossal schwannoma.A case report[J]. Mangetic Resonance Imgaing 21(2003)155-158.
[7]Bekta(?) D, Caylan R. Bilateral hypoglossal schwannoma: a radiologic diagnosis [J]. Kulak Burun Bogaz Ihtis Derg. 2004; 12(1-2):45-7.
[8]Mori K, Nakao Y, Yamamoto T, et al. Intradural jugular tuberclectomy in a case of inadequate extradural removal. Surg Neurol. 2005 Oct; 64(4):347-50;discussion 350.
[9]Tatagiba M, Koerbel A, Roser F. The midline suboccipital subtonsillar approach to the hypoglossal canal:surgical anatomy and clinical application[J].Acta Neurochir(Wien).2006 Sep;148(9):965-9.Epub 2006 Jul 5.
[10]Kikkawa Y,Shono T,Mizoguchi M,et al.A case of intracranial hypoglossal neurinoma without hypoglossal nerve palsy:operative view of the preserved rostral trunk[J].Minim Invasive Neurosurg.2007 Oct;50(5):296-9.
[11]Tucker A,Miyake H,Tsuji M,et al.Intradural microsurgery and extradural gamma knife surgery for hypoglossal schwannoma:case report and review of the literature[J].Minim Invasive Neurosurg.2007 Dec;50(6):374-8.
[12]Gabriel Calzada,M.D.,Brandon Isaacson,M.D.,Daniel Yoshor,M.D.,et al.Surgical Approaches to the Hypoglossal Canal[J].Skull Base.2007 May;17(3):187-196.
[13]Kuo LT,Huang AP,Kuo KT,et al.Extradural dumbbell schwannoma of the hypoglossal nerve:a case report with review of the literature[J].Surg Neurol.2008Dec;70 Suppl 1:S1:34-8;discussion S1:38-9.Epub 2008 Apr 18.
[14]杨江帆.舌下神经鞘瘤1例[J].中国肿瘤临床,1994;2:156.
[15]梁勇,周良辅,毛颖,等.舌下神经鞘瘤的诊断和治疗[J].中国神经精神疾病杂志,1997;23(6):321-3.
[16]周定标,程东源.舌下神经鞘瘤[J].中华神经外科杂志,1999;15(1):42-44.
[17]蒋敏,谭继善.舌下神经鞘瘤的CT和MRI表现及其病理基础(附4例报告)[J].实用医学影像杂志,2002;3(2):137-139.
[18]谭学书,刘平.舌下神经鞘瘤恶变一例[J].中华神经外科杂志,2003;19(6):420.
[19]汪恒望,韩萍,梁波,等.舌下神经鞘瘤一例[J].临床放射学杂志,2003;22(8):679.
[20]杨百春,周良辅,毛颖,等.舌下神经鞘瘤诊断和治疗[J].中华外科杂志,2004;42(22):1384-8.
[21]金中高,周林江,姚振威.舌下神经鞘瘤的临床和MRI诊断[J].中华神经外科杂志,2007;23(9):669-671.
[22]陈志,冯华,朱刚.哑铃型舌下神经鞘瘤1例[J].第三军医大学学报.2007;29(17):1715-1723.
[23]吴震,张俊廷,贾桂军.耳后经髁上入路切除颈静脉孔区及舌下神经孔区肿瘤32例[J].中华外科杂志,2004;42(3):173-175.
[24]贾桂军,王忠诚,张俊廷.舌下神经孔区神经鞘瘤的诊断与显微外科治疗[J].中华医学杂志,2001;81(20):1264-1265.
[25]Foer DB,Hermans R,Sciot R,et al.Imaging case study of the month hypoglossal schwannoma.Ann Otol Rhinol Laryngol,1995,104:490-492.
[26]Sato M,Kanai N,Fukushima Y,et al.Hypoglossal neurinoma extending intraand extracranially:case report.Surg Neurol,1996,45:172-175.
[27]Morelli RJ.Intracranial neurilemmoma of the hypoglossal nevre.Review Report[J].Neurology.1966Jul;16(7):709-13.
[28]Fujiwara M,Bitoh S,Hasegawa H,et al.A case of intracranial hypoglossal neurinoma(author'transl)[J].No Shinkei Geka.1981 Jul;9(8):953-8.
[29]Kuramitsu T,Seiki,Y Shibata I,et al.A case of intracranial hypoglossal neurinoma[J].No Shinkei Geka.1986 Nov;14(12):1463-9.
[30]Yamaguchi F, Takahashi H, Okada T, et al.A case of intracranial hypoglossal neurinoma with no preoperative hypoglossal nevre palsy[J].No Shinkei Geka.1990; 18(10):963-7.
[3 l] Takahashi, Tominaga T, Sato Y et al.Hypoglossal neurinoma presenting with intratumoral hemorrhage[J].J Clin Neurosci.2002 Nov; 9(6):716-9.
[32]Krauss JK, Bertalanffy H, Schwechheimer K, et al Ventral brain stem Schv/annoma at the entry zone of the hypoglossal nevre.Neurochirurgia(Stuttg)[J]. 1993 Mar; 36(2):66-9.
[33]Kobayashi S, Otsuka A, Tsunoda T, et al.Intracranial hypoglossal neurinoma without preoperative hypoglossal nevre paresis-case report[J]Neuro133 Med Chir(Tokyo).1996 Jun; 36(6):384-7.
[34]Sarma S, Sekhar LN, Schessel DA.Nonvestibular schwannomas of the brain: a 7-year experience[J].Neurosurgery, 2002; 50(3):437-449.
[35]Gilsbach JM, Sure U, Mann W.The supracondylar approach to the jugular tubercle and hypoglossal canal[J].Surg Neurol 1998:50:563-70.
[36]Passacantilli E, Lanzino G, Henn JS, et al.Intracranial extradural schwannoma of the 12 th cranial nevre.Case illustration[J].J Neurosurg.2003; 98(1):219.
[37]McCurdy JA Jr, Hays LL, Johnson GK.Parapharyngeal neurilemmoma of the hyoglossal nevre[J], Laryngoscope. 1976 May; 86(5):724-7.
[38]FleuryP, Laccourreye H, Basset JM, et al.An impressively lagre trilobulate neuroma of the XIIth cranial nerve (author's transl)[J].Ann Otolaryngol Chir Cervicofac.1979 Sep-Oct; 96(10-11):781-8.
[39]Sutay S , Tekinsoy B , Ceryan K , et al.Submaxillary hypoglossaJ neurilemmoma[J].J Laryngol Otol.1993 Oct; 107(10):953-4.
[40]De Foer B, Hermans R, Sciot R, et al.Hypoglossal schwannoma[J].Ann Otol Rhinol Laryngol. 1995 Jun; 104(6):490-2.
[41]Ogawa T, Kitagawa Y, ogasawara T.A multifocal neurinoma of the hypoglossal nerve with motor paralysis confirmed by electromyography[J].Int J Oral Maxillofac Surg.2001 Apr; 30(2): 176-8.
[42]Chang KC , Leu YS.Hypoglossal schwannoma in the submandibular space[J].The Journal of Laryngology and Otology, 2002:116(1):63.
[43]Myatt HM, Holland NJ, Cheesman AD.A skul 1 base exrtadural hypoglossal neurilemmoma resected via an extended posterolateral apporach[J].J Laryngol Otol. 1998 Nov; 112(11): 1052-7.
[1]Karasu A,Cansever T,Batay F,et al.The microsurgical anatomy of the hypoglossal canal[J].Surg Radiol Anat.2009 Jan 14.[Epub ahead of print].
[2]Lang J.Skull base and related structures.见孙为群,滕良珠主译.颅底与相关结构临床解剖图谱[M].山东,山东科学技术出版社:274-312,2002.
[3]丁白海,于春江,田德润,等.颅颈结合区的显微外科解剖[J].中华外科杂志,2002;40:427-430
[4]Rhoton AL.The foramen magnum[J].Neurosurgery 2000;47:5155-193.
[5]Naguib M,Aristegui M,Cokkeser Y,et al.Lower skullbase:anatomical study with surgical implications[J].Ann Otol Rhinol Laryngol 1995,104:57-61.
[6]Wysocki J,Kobryn H,Bubrowski M,et al.The morphology of the hypoglossal canal and its size in relation to skull capacity in man and other mammal species[J].Folia Morphol(Warsz).2004;63(1):11-7.
[7]VoVyodic F,Whyte A,Slavotinek J.The hypoglossal canal:normal MR Enhancement pattern[J].1995,AJNR 16:1707-1710.
[8]Day JD,Kellogg JX,Tschabitscher M,et al.Surface and superficial surgical anatomy of the posterolateral craniall base:significance for surgical planning and approach[J].Neurosurgery,1996;38(6):1079-1083.
[9]Avci E,Kocaogullar Y,Fossett D,et al.Lateral posterior fossa venous sinus relationships to surface lanmarks[J].Surg Neurol.2003;59(5):392-397.
[10]Uz A,Ugur HC,Tekdemir I.Is the asterion a reliable landmark for the lateral approach to posterior fossa?[J].J Clin Neurosci.2001;8(2):146-147.
[11]Gusmao S,Reis C,Tazinaffo U,et al.Definition of the anterolateral occipital lobe limit in anatomical specimens and image examination[J].Arq Neuropsiquiatr.2002;60(1):41-46.
[12]Ucerler H,Govsa F.Asterion as a surgical landmark for lateral cranial base approaches[J].J Craniomaxillofac Surg.2006 Oct;34(7):415-20.Epub 2006 Sep 11.
[13]杨百春,周良辅,毛颖,等.舌下神经鞘瘤诊断和治疗[J].中华外科杂志,2004;42(22):1384-8.
[14]高士镰,吕永利,张力伟.实用脑血管图谱[M].北京,科学技术出版社,2002:79-88.
[15]Wen HT,Rhoton AL,Katsuta T,et al.Microsurgical anatomy of the transcondylar,supracondylar,and paracondylar extensions of the far-lateral approach[J].J Neurosurg,1997;87:555-585.
[16]Spektor S,Anderson GJ,Memenomey SO,et al.Quantitative description of the far-lateral transcondylar transtubercular approach to the foramen and cliuvs[J].J Nuerosrug 92:824-831,2000.
[17]J Neurosurg.2006 Nov;105(5):753-7.Jugular tubercle:Morphometric analysis and surgical significance.Mintelis A,Sameshima T,Bulsara KR,Gray L,Friedman AH,Fukushima T.
[18]Samii M,Babu RP,Tatagiba M,et al.Surgical treatment of jugular foramen schwannomas[J1.JNeurosurg1995;82(6):924-32.
[19]Market JM,Chanddler WF,Deveikis JP,et al.Use of the exrteme lateral approach in the sugrical treatment of an intradural ventral cevrical spinal cord vascular malformation technical case report[J].Neurosurgery,1996,38:412-415.
[20]贾桂军,王忠诚,张俊廷.舌下神经孔区神经鞘瘤的诊断与显微外科治疗[J].中华医学杂志,2001;81(20):1264-1265.
[21]Sarma S,Sekhar LN,Schessel DA.Nonvestibular schwannomas of the brain:a 7-year experience[J].Neurosurgery,2002;50(3):437-449.
[22]吴震,张俊廷,贾桂军.耳后经髁上入路切除颈静脉孔区及舌下神经孔区肿瘤32例[J].中华外科杂志,2004;42(3):173-175.
[1]杨百春,周良辅,毛颖,等.舌下神经鞘瘤诊断与治疗[]J.中华外科杂志,2004;42(22):1384-8.
[2]Morelli RJ.Intracranial neurilemmoma of the hypoglossal nevre.Review and case report[J].Neuorlogy.1966Jul;16(7):709-13.
[3]Fujiwara M,Bitoh S,Hasegawa H,et al.A case of intracranial hypoglossal neurinoma(author's,transl)[J].No Shinkei Geka.1981 Jul;9(8):953-8.
[4]Kuramitsu T,Seiki Y,Shibata I,et al.A case of intracranial hypoglossal neurinonal[J].No Shinkei Geka.1986 Nov:14(12):1463-9.
[5]Yamaguchi F,Takahashi H,Okada T,et al.A case of intracranial hypoglossal neurinoma with no peroperative hypoglossal nevre palsy[J].No Shinkei Geka.1990Oct;18(10):963-7.
[6]Samra S,Sekhar LN,Schessel DA.Nonvestibular schwannomas of the brain:a year experience[J].Neurosurger y,2002;50(3):437-49.
[7]Passacantilli E,Lanzino G,Henn JS,et al.Intracranial extradural schwannoma of the 12th cranial nevre.Case illustration[J].J Neurosurg.2003 98(1):219..
[8]Gabriel Calzada,M.D.,Brandon Isaacson,M.D.,Daniel Yoshor,M.D.,et al.Surgical Approaches to the Hypoglossal Canal[J].Skull Base.2007 May;17(3):187-196.
[9]刘庆良,王忠诚,于春江,等.颈静脉孔区显微解剖[J].中华神经外科杂志,2004,20(1):10-13.
[10]朱权,袁贤瑞,刘庆,等.应用枕下经颈静脉突入路显微手术切除颈静脉孔 区肿瘤[J].中华神经外科杂志 2006,22(7):391-395.
[11]吴波,游潮,蔡博文,等.远外侧入路治疗颅颈交界腹侧病变的探讨[J].中华外科杂志,2005,43(9):612-615.
[12]Kawashima M,Tanriover N,Rhoton AL et al Comparison of the far lateral and extreme lateral variants of the atlanto-occipital transarticular approach to anterior extradural lesions of the craniovertebral junction[J].Neurosurgery,2003;53(3):662-675.
[13]张俊廷,王忠诚,昊震,等.枕骨大孔区脑膜瘤显微外科手术治疗[J].中华神经外科杂志2000,16(3):159-161.
[1]Boulton MR,Cusimano MD.Foramen magnum meningiomas:concepts,classifications,and nuances[J].Neurosurg Focus.2003 Jun 15;14(6):e10.
[2]冯东侠,叶富华,徐卫东,等.枕髁形态学分类对下斜坡病变的手术意义[J].中华神经外科杂志,2007,23(4)253-256.
[3]武志强,张绍祥,王斌全,等.基于数字化人体的颞骨可视化模型初步研究[J].实用医技杂志,2008,15(17):2188-2190.
[4]Salas E,Sekhar LN,Ziyal IM,et al.Variations of the extreme-lateral craniocervical approach:anatomical study and clinical analysis of 69 patients[J].J Neurosurg.1999 Apr;90(2 Suppl):206-19.
[5]Bejjani GK,Sekhar LN,Riedel CJ.Occipitocervical fusion following the extreme lateral transcondylar approach[J].Surg Neurol.2000 Aug;54(2):109-15;discussion 115-6.
[6]Vishteh AG,Crawford NR,Melton MS,Stability of the craniovertebral junction after unilateral occipital condyle resection:a biomechanical study[J].J Neurosurg.1999 Jan;90(1 Suppl):91-8.
[1]Arnold H.Menezes MD.Transoral Approaches to the Craniocervical Junction[J].Operative Techniques in Neurosurgery,2005;8(3):116-124.
[2]Katsuta T,Rhoton AL Jr,Matsushimu T.The jugular foramen:microsurgical anatomy and operative approaches[J].Neurosurgery,1997;41(1):194-202.
[3]Ozveren MF,Ture U,Ozek MM,et al.Anatomic landmarks of the glossopharyngeal nerve:a microsurgical anatomic study.Neurosurgery,2003;52(6)1400-1410.
[4]Duvernor HM.Human brain stem vessals(2nd edition):Springe Verlag:Berlin,Heidelberg,1999:28-32.
[5]张力伟,王忠诚,于春江.延髓腹外侧动脉显微外科研究.中华神经外科杂志,2001;17(6)357-360.
[6]Mitsuhashi Y,Nishio A,Kawahara S,et al.Morphologic evaluation of the caudal end of the inferior petrosal sinus using 3D rotational venography[J].AJNR Am J Neuroradiol.2007 Jun-Jul;28(6):1179-84
[7]Rhoton AL Jr.The Cerebellopontine Angle and Posterior fossa cranial nerves by the retrosigmoid approach[J].Neurosurgery(Supplement),2000;47(3):93-129.
[8]Krishnamurthy A,Nayak SR,Khan S,et al.Arcuate foramen of atlas:incidence,phylogenetic and clinical significance[J].Rom J Morphol Embryol.2007;48(3):263-266.
[9]种衍军.舌咽神经痛的手术治疗与病因学探讨[J].中华神经外科杂志, 1999;15(2):94-96.
[10]Ryan S,Blyth P,Duggan N,,et al.Is the cranial accessory nerve really a portion of the accessory nerve? Anatomy of the cranial nerves in the jugular foramen[J].Anat Sci Int.2007 Mar;82(1):1-7.
[11]葛明,张俊廷,吴震,等.远外侧入路切除颅颈区肿瘤[J].中华显微外科杂志,2001;24:230-231.
[12]Wen HT,Rhoton AL Jr,Katsuta T,et al.Microsurgical anatomy of the transcondylar,supracondylar,and paracondylar extensions of the far-lateral approach[J].J Neurosurg,19971;87:555-585.
[13]Bruneau M,George B.Foramen magnum meningiomas:detailed surgical approaches and technical aspects at Lariboisiere Hospital and review of the literature[J].Neurosurg Rev.2007;31(1):19-33.
[14]陈刚,陈坚,王仲伟,等.枕骨大孔区脑膜瘤的外科治疗[J].中国耳鼻咽喉颅底外科杂志,2001,7(4):212.
[15]漆松涛.显微神经外科手术图解及述评[M].人民卫生出版社,2003.6:37.
[1]Fisch,U.;Infratemporal fossa approach for glomus tumors of the temporal bone.Ann Otol Rhinol Laryngol.1982;91:474-479.
[2]Oghalai, J S; Leung, M K Jackler, R K; McDermott, M W.; Transjugular craniotomy for the management of jugular foramen tumors with intracranial extension. Otol Neurotol. 2004; 25:570-579. [3]Smith, P G; Backer, R J Kletzker, GR; et al. Surgical management of transcranial hypoglossal schwannomas. Am J Otol. 1995; 16:451-456.
[4]Wen, HT; Rhoton, A L, Jr Katsuta, T; de Oliveira, E.; Microsurgical anatomy of the transcondylar, supracondylar, and paracondylar extensions of the far-lateral approach. J Neurosurg. 1997; 87:555-585.
[5]Oghalai, J S; Leung, M K Jackler, R K; McDermott, M W.; Transjugular craniotomy for the management of jugular foramen tumors with intracranial extension. Otol Neurotol. 2004; 25:570-579.
[6]Sekhar, L N Estonillo, R.; Transtemporal approach to the skull base: an anatomical study. Neurosurgery. 1986; 19:799-808.
[7]Rhoton AL.The foramen magnum[J].Neuorsurg 2000; 47:S 155-193.
[8]Naguib M, Aristegui M, Cokkeser Y, et al.Lower skullbase: anatomical study with surgical implications[J].Ann Otol Rhinol Laryngol 1995 , 104:57-61.
[9]Wysocki J, Kobryn H, Bubrowski M, et al.The morphology of the hypoglossal canal and its size in relation to skull capacity in man and other mammal species[J].Folia Morphol(Warsz).2004; 63(1):11-7.
[10]By GEOFFREY A.WARDWELL,M.D.,JOHN A.GOREE,M.D., JOHN P.JIMENEZ,M.D..THE HYPOGLOSSAL ARTERY AND HYPOGLOSSAL AND HYPOGLOSSAL CANAL[J]. Am. J. Roentgenol, Jul 1973; 118: 528-533.
[11]Elhammady MS, Ba(?)kaya MK, Sonmez OF,et al. Persistent primitive hypoglossal artery with retrograde flow from the vertebrobasilar system: a case report[J]. Neurosurg Rev. 2007 Oct; 30(4):345-9; discussion 349. Epub 2007 Aug 9.
[12]VoVyodic F, Whyte A, Slavotinek J.The hypoglossal canal:normal MR Enhancement pattern[J].AJNR 16:1707-1710, 1995.
[13]Baldauf J, Junghans D, Schroeder HW. Endoscope-assisted microsurgical resection of an intraneural ganglion cyst of the hypoglossal nerve[J]. J Neurosurg. 2006 Jun; 104(6):990-2; author reply 992.
[14]Chennupati SK, Norris R, Dunham B,et al. Osteosarcoma of the skull base: case report and review of literature[J]. Int J Pediatr Otorhinolaryngol. 2008 Jan; 72(1):115-9. Epub 2007 Nov 5.
[15]De Martel T, Subirana A, Guillaume J.Los tumores de le fosa cerebral posterior voluminoso neurinoma del hipogloso con desarrollo juxtabullbo-protuberan[j]Operacioncuracion Ars Med 1933; 9:416-9.
[16]Rachinger J, et al.Dumbbell-shaped hypoglossal schwannoma.A case report[J].Mangetic Resonance Imgaing 21(2003)155-158
[17]Bekta(?) D, Caylan R. Bilateral hypoglossal schwannoma: a radiologic diagnosis[J]. Kulak Burun Bogaz Ihtis Derg. 2004; 12(1-2):45-7.
[18]Mori K, Nakao Y, Yamamoto T, et al. Intradural jugular tuberclectomy in a case of inadequate extradural removal. Surg Neurol. 2005 Oct ; 64(4):347-50; discussion 350.
[19]Tatagiba M, Koerbel A, Roser F. The midline suboccipital subtonsillar approach to the hypoglossal canal: surgical anatomy and clinical application[J]. Acta Neurochir (Wien). 2006 Sep; 148(9):965-9. Epub 2006 Jul 5.
[20]Kikkawa Y, Shono T, Mizoguchi M,et al. A case of intracranial hypoglossal neurinoma without hypoglossal nerve palsy: operative view of the preserved rostral trunk[J]. Minim Invasive Neurosurg. 2007 Oct; 50(5):296-9.
[21]Tucker A, Miyake H, Tsuji M,et al. Intradural microsurgery and extradural gamma knife surgery for hypoglossal schwannoma: case report and review of the literature[J]. Minim Invasive Neurosurg. 2007 Dec; 50(6):374-8.
[22]Gabriel Calzada, M.D.,1 Brandon Isaacson, M.D.,1 Daniel Yoshor, M.D.,2 et al. Surgical Approaches to the Hypoglossal Canal[J]. Skull Base. 2007 May; 17(3): 187-196.
[23]Kuo LT, Huang AP, Kuo KT, et al. Extradural dumbbell schwannoma of the hypoglossal nerve: a case report with review of the literature[J]. Surg Neurol. 2008 Dec; 70 Suppl 1 :S 1:34-8; discussion S1:38-9. Epub 2008 Apr 18.
[24] 杨江帆.舌下神经鞘瘤1例[J].中国肿瘤临床 ,1994；2：156.
[25]梁勇,周良辅,毛颖,等.舌下神经鞘瘤的诊断和治疗[J].中国神经精神疾病杂志,1997;23(6):321-3.
[26]舌下神经鞘瘤[J].中华神经外科杂志,1999;15(1):42-44.
[27]蒋敏,谭继善.舌下神经鞘瘤的CT和MRI表现及其病理基础(附4例报告)[J].实用医学影像杂志,2002;3(2):137-139.
[28]谭学书,刘平.舌下神经鞘瘤恶变一例[J].中华神经外科杂志,2003;19(6):420.
[29]汪恒望,韩萍,梁波,等.舌下神经鞘瘤一例[J].临床放射学杂志,2003;22(8):679.
[30]杨百春,周良辅,毛颖,等.舌下神经鞘瘤诊断和治疗[J].中华外科杂志,2004;42(22):1384-8.
[31]金中高,周林江,姚振威.舌下神经鞘瘤的临床和MRI诊断[J].中华神经外科杂志,2007;23(9):669-671.
[32]陈志,冯华,朱刚.哑铃型舌下神经鞘瘤1例[J].第三军医大学学报.2007;29(17):1715-1723.
[33]吴震,张俊廷,贾桂军.耳后经髁上人路切除颈静脉孔区及舌下神经孔区肿瘤32例[J].中华外科杂志,2004;42(3):173-175.
[34]贾桂军,王忠诚,张俊廷.舌下神经孔区神经鞘瘤的诊断与显微外科治疗[J].中华医学杂志,2001;81(20):1264-1265.
[35]Foer DB,Hermans R,Sciot R,et al.Imaging case study of the month hypoglossal schwannoma.Ann Otol Rhinol Laryngol,1995,104:490-492.
[36]Sato M,Kanai N,Fukushima Y,et al.Hypoglossal neurinoma extending intra-and extracranially: case report. Surg Neurol , 1996 , 45 : 172-175.
[37]Morelli RJ.Intracranial neurilemmoma of the hypoglossal nevre.Review Report [J].Neurology.l966Jul; 16(7):709-13.
[38]Fujiwara M, Bitoh S, Hasegawa H, et al.A case of intracranial hypoglossal neurinoma(author'transl)[J].No Shinkei Geka.1981 Jul ; 9(8):953-8.
[39]Kuramitsu T, Seiki, Y Shibata I, et al.A case of intracranial hypoglossal neurinoma[J].No Shinkei Geka.1986 Nov; 14(12): 1463-9.
[40]Yamaguchi F, Takahashi H, Okada T, et al.A case of intracranial hypoglossal neurinoma with no preoperative hypoglossal nevre palsy[J].No Shinkei Geka. 1990; 18(10):963-7.
[41]Takahashi, Tominaga T, Sato Y et al.Hypoglossal neurinoma presenting with intratumoral hemorrhage[J].J Clin Neurosci.2002 Nov; 9(6):716-9.
[42]Krauss JK, Bertalanffy H, Schwechheimer K, et al Ventral brain stem Schwannoma at the entry zone of the hypoglossal nevre.Neurochirurgia(Stuttg)[J].1993 Mar; 36(2):66-9.
[43]Kobayashi S, Otsuka A, Tsunoda T, et al.Intracranial hypoglossal neurinoma without preoperative hypoglossal nevre paresis-case report[J]Neuro 133 Med Chir(Tokyo).1996 Jun; 36(6):384-7.
[44]Sarma S, Sekhar LN, Schessel DA.Nonvestibular schwannomas of the brain: a 7-year experience[J].Neurosurgery, 2002; 50(3):437-449.
[45]Gilsbach JM, Sure U, Mann W.The supracondylar approach to the jugular tubercle and hypoglossal canal[J].Surg Neurol 1998:50:563-70.
[46]Passacantilli E, Lanzino G, Henn JS, et al.Intracranial extradural schwannoma of the 12 th cranial nevre.Case illustration[J].J Neurosurg.2003; 98(1):219.
[47]Kempe LG(1970).Operative neurosurgery[M], Vol 2.Springer, Berlin Heidelberg New York, pp34-35, 46-53, 72-79.
[48]Miller R(1979).Meningiomas of the posterior fossa[M].In:Buchheit WA(eds).Surgery of the posterior fossa.Raven, New York, 99-100.
[49]Rhoton AL Jr, de oliveira E.Suboccipital and retrosigmoid approaches to the craniovertebral junction, in Dickman CA, Spetzler RF, Sonntag VKH(eds):Surgery of the Craniovertebral Junction[M].New York, Thieme Medical Publishers, Inc, 1998, pp659-681.
[50]Sen CN, Sekhar LN.Surgical management of anteriorly placed lesions at the craniocervical junction-an alternative approach[J].Acta Neurochir(Wien)1991; 108:70-77.
[51]Seeger W, Atlas of Topographical structures.Wein:Spinger.Verlag[J], 1978, Anatomy of the Brain and Surrounding 25:486-4892.
[52]Heros RC.Lateral suboccipital approach for vertebra and veterbrobasilar artery lesions[J].JNeurosurgery, 1986, 20:207-214.
[53]Spetzler RF.Grahm TW.The far lateral approach to the inferior clivus and the upper cervical region.technical note[J].Barrow Neuroliyical Institute Quarterly 1990, 6:35-38.
[54]Bertanlanffy H, Seeger W, The dorsolateral, suboccipital.transcondylar approach to the lower clivus and anterior portion of the craniocervical junction[J], Neurosurg, 1991, 29:815-821.
[55]Sekhar LN, Jannetta PJ, Bukrhart LE, et al.Meningioma involving the clivus a years experience with 41 patients[J].Neurosurgery, 1990, 27:764-781.
[56]Schilling V, Grevers G, Miller A.Eine Moddification des transcondylar Zugang Zum Foramen jugulare Klin[J].Moatsbl.Augenheikd, 1996, 41:209-223.
[57]Seyffed Dmand Rock JP.The transcondylar approach to the Juglar Foramen:A comparative Anatomic study[J].Surg Neuorl, 1994, 42:265-71.
[58]Market JM, Chanddler WF, Deveikis JP,et al.Use of the exrteme lateral approach in the sugrical treatment of an intradural ventral cevrical spinal cord vascular malformation technical case report[J]. Neurosurgery, 1996, 38:412-415.
[59]John E, Wanebo.M.D.Quantitive Analysis of the Transcondylar approch to the Foramen Magnum[J].Neurosurgery, 2001, 49:934-955.
[60]Nanda A, Vincent DA, Vannemreddy PSSV, et al.Far-lateral approch to Intradural lesions of the foramen magnum without resection of the occipital condyle[J].J Neurosurg 2002; 96:302-09
[61]Wanebo,JE, Chicoine MR.Quantitative analysis of the transcondylar approch to the foramen magnum[J]. Neurosurg 2001; 49:934-943.
[62]Spektor S, Anderson GJ, Memenomey SO, et al.Quantitative description of the far-lateral transcondylar transtubercular approach to the foramen and cliuvs[J] .J Nuerosrug 92:824-831, 2000.
[63]Wen HT, Rhoton AL, Katsuta T, et al.Microsurgical anatomy of the transcondylar, supracondylar, and paracondylar extensions of the far-lateral approach[J].J Neurosurg, 1997; 87:555-585.
[64]Salas E, Sekhar LN, Ziyal IM, et al.Variations of the extreme-lateral craniocervical approach:anatomical study and clinical analysis of 69 patients[J]. JNeurosurg, (Spine 2)90:206-219, 1999.
[65]Vishtch AG, Crawford NR, Melton MS , et al.Stablitiy of the craniovertibral junction after unilateral occipitial condyle resection:a biomechanical study[J].Spine, 1999; 90(1):91-8.
[66]Babu RP, Sekhar LN, Wright DC.Extreme lateral transcondylar approach: Technical improvements and lessons leamed[J].JNeurosurg 1994, 81:49-59.
[67]Sen CN, Sekhar LN.An extreme lateral apporach to intradural lesions of the cervical spine and foramen magnum[J].Neurosurgery 1990; 27:197-204.
[68]George B, Dematons C, Cophignon J.Lateral approach to the anterior portion of the foramen magnum Application to surgical removal of 14 benign tumors:technical note[J].Surg Neurol 1988, 29:484-490.
[69]Matsushima T, Matsukado K, Natori Y, et al.Surgery on a saccular vertebral artery-posterior inferior cerebellar artery aneurysm via the transcondylar fossa (supracondylar transjugular tubercle)approach: surgical results and indications for using two different lateral skull base approaches[J]JNeurosurg, 2001; 95:268-274.
[70]Fisch, U Pillsbury, H C; Infratemporal fossa approach to lesions in the temporal bone and base of the skull. Arch Otolaryngol. 1979; 105:99-107.
[71]Glassock, M E, III; Jackson, C G Dickins, J R; Wiet, R J.; Panel discussion: glomus jugulare tumors of the temporal bone-the surgical management of glomus tumors. Laryngoscope. 1979; 89:1640-1654.
[72]Hadley, K S Shelton, C. ; Infratemporal fossa approach to the hypoglossal canal: practical landmarks for elusive anatomy. Laryngoscope. 2004; 114:1648-1651.
[73] Fisch, U.; Infratemporal fossa approach for glomus tumors of the temporal bone. Ann Otol Rhinol Laryngol. 1982; 91:474-479.
[74]Franklin, D J; Moore, G F; Fisch, U.; Jugular foramen peripheral nerve sheath tumors. Laryngoscope. 1989; 99:1081-1087.
[75]Sekhar LN , Schramm VL , Jones NF.Subtemporal-preauricular infratemporal fossa approach to large lateral and posteriorcranial base neoplasms[J].J Neurosurg, 1987; 67: 488-499.
[76]Sen CN, Sehhar LN.The subtemporal and preauricular infratemporal approach to intradural structures ventral to the brain stem[J].J Neurosurg, 1990; 73: 345-354.
[77]McCurdy JA Jr, Hays LL, Johnson GK.Parapharyngeal neurilemmoma of the hyoglossal nevre[J], Laryngoscope. 1976 May; 86(5):724-7.
[78]Fleury P, Laccourreye H, Basset JM, et al.An impressively lagre trilobulate neuroma of the XIIth cranial nerve (author's transl)[J].Ann Otolaryngol Chir Cervicofac.1979 Sep-Oct; 96(10-11):781-8.
[79]Sutay S, Tekinsoy B, Ceryan K, et al.Submaxillary hypoglossal neurilemmoma[J].J Laryngol Otol.1993 Oct; 107(10):953-4.
[80]De Foer B, Hermans R, Sciot R, et al.Hypoglossal schwannoma[J].Ann Otol Rhinol Laryngol. 1995 Jun; 104(6):490-2.
[81]Ogawa T, Kitagawa Y, ogasawara T.A multifocal neurinoma of the hypoglossal nerve with motor paralysis confirmed by electromyography[J].Int J Oral Maxillofac Surg.2001 Apr; 30(2): 176-8.
[82]Chang KC, Leu YS.Hypoglossal schwannoma in the submandibular space[J].The Journal of Laryngology and Otology, 2002:116(1).63.
[83]Myatt HM, Holland NJ, Cheesman AD.A skul 1 base exrtadural hypoglossal neurilemmoma resected via an extended posterolateral apporach[J].J Laryngol Otol.1998 Nov; 112(11):1052-7.
[84]Bordi TL, Cheesman AD, Symon L.The surgical management of glomus jugulare tumors-description of a single-staged posterolateral combined otoneurosurgical approach[J].Br J Neurosurg, 1989; 3(1):21 -30.
[85]Samii M, Babu RP, Tatagiba M, et al.Surgical management of jugular foramen schwannomas[J]J Neurosurg 1995:82(6):924-32.
[86]Serizawa T, Yamaura A, Osato K, et al.A case of intracranial hypoglossal neurinoma [J].No Shinkei Geka.1989 Mar; 17(3):279-83.
[87]Kachhara R, Nair S, Radhakrishnan VV.Large dumbbell neurinoma of Hypoglossal nevre:case report[J].Br J Neuorsurg. 1999 Jun; 13(3):338-40.
[88]Hoshi M, Yoshida K, Ogawa K, et al.Hypoglossal neurinoma case reports[J].Neurol Med Chir(Tokyo).2000 Sep; 40(9):489-93.
[89]Rachinger J, Fellner AF, Trenkler J.Dumbbell-shaped hypoglossal schwannoma.A case report[J].Mangnetic Resonnace Imgaing 21 (2003) 155-158.
[90]Odake G. Intracranial hypoglossal neurinoma with exrtacranial extension:review and case report[J].Neurosurgery, 24(4):583-587, 1989.
[91]Kamitani H , Masuzawa H , Kanazawa I , et al.A combined exrtadural-posterior petrous and suboccipital approach to the jugular foramen tumors[J].Acta Neurochir(Wien). 1994; 126(2-4): 179-84.
[92]Fujita K, Nozkai K, Nagata I, et al.A case of dumbbell-shaped hypoglossal neurinoma[J].No Shinkei Geka. 1994 Aug; 22(8):775-9.
[93]Smith PG,Backer RJ, Kletzker GR, et al.Surgical management of transcranial hypoglossal schwannomas[J].Am J Otol. 1995 Jul; 16(4):451 -6.
[94]Sato M, Kanai N, Fukushima, et al. Hypoglossal neurinoma extending intra-and extracraniallyxase report[J].Surg Neurol 1996; 45:172-5.
[95]Spinnato S , Talacchi A , Musumeci A , et al.Dumbbell-Shaped Neurinoma:Surgical Removal via a dorsolateral transcondylar approch.A Case Report and Review of the Literature[J].Acta Neuorchir(Wien) (1998) 140: 827-832.
[96]Canalis RF, Martin N, Black Keith, et al.Lateral approach to tumors of the craniovertebral junction[J].Laryngoscope 103:343-47, 1993.
[97]Bunc VG, Milojkovic G, Kosceir S, et al.Dumb-bell hypoglossal neurinoma.With Intra-and Extracranial Paravertebral Expansion[J].Acta Neurochir(Wien)(1998) 140:1209-1210.
[98]Hakuba A, Hashi K, Fujitani K, et al.Jugular foramen neurinomas[J].Surg Neurol 1979; 11:83-94.
[3]Baldauf J, Junghans D, Schroeder HW. Endoscope-assisted microsurgical resection of an intraneural ganglion cyst of the hypoglossal nerve[J]. J Neurosurg. 2006 Jun; 104(6):990-2; author reply 992.
[4]Chennupati SK, Norris R, Dunham B,et al. Osteosarcoma of the skull base: case report and review of literature[J]. Int J Pediatr Otorhinolaryngol. 2008 Jan; 72(1):115-9. Epub 2007 Nov 5.
[5]De Mattel T, Subirana A, Guillaume J.Los tumores de le fosa cerebral posterior voluminoso neurinoma del hipogloso con desarrollo juxtabullbo- protuberan[j]. Operacioncuracion Ars Med 1933; 9:416-9.
[6]Rachinger J, et al.Dumbbell-shaped hypoglossal schwannoma.A case report[J]. Mangetic Resonance Imgaing 21(2003)155-158.
[7]Bekta(?) D, Caylan R. Bilateral hypoglossal schwannoma: a radiologic diagnosis [J]. Kulak Burun Bogaz Ihtis Derg. 2004; 12(1-2):45-7.
[8]Mori K, Nakao Y, Yamamoto T, et al. Intradural jugular tuberclectomy in a case of inadequate extradural removal. Surg Neurol. 2005 Oct; 64(4):347-50;discussion 350.
[9]Tatagiba M, Koerbel A, Roser F. The midline suboccipital subtonsillar approach to the hypoglossal canal:surgical anatomy and clinical application[J].Acta Neurochir(Wien).2006 Sep;148(9):965-9.Epub 2006 Jul 5.
[10]Kikkawa Y,Shono T,Mizoguchi M,et al.A case of intracranial hypoglossal neurinoma without hypoglossal nerve palsy:operative view of the preserved rostral trunk[J].Minim Invasive Neurosurg.2007 Oct;50(5):296-9.
[11]Tucker A,Miyake H,Tsuji M,et al.Intradural microsurgery and extradural gamma knife surgery for hypoglossal schwannoma:case report and review of the literature[J].Minim Invasive Neurosurg.2007 Dec;50(6):374-8.
[12]Gabriel Calzada,M.D.,Brandon Isaacson,M.D.,Daniel Yoshor,M.D.,et al.Surgical Approaches to the Hypoglossal Canal[J].Skull Base.2007 May;17(3):187-196.
[13]Kuo LT,Huang AP,Kuo KT,et al.Extradural dumbbell schwannoma of the hypoglossal nerve:a case report with review of the literature[J].Surg Neurol.2008Dec;70 Suppl 1:S1:34-8;discussion S1:38-9.Epub 2008 Apr 18.
[14]杨江帆.舌下神经鞘瘤1例[J].中国肿瘤临床,1994;2:156.
[15]梁勇,周良辅,毛颖,等.舌下神经鞘瘤的诊断和治疗[J].中国神经精神疾病杂志,1997;23(6):321-3.
[16]周定标,程东源.舌下神经鞘瘤[J].中华神经外科杂志,1999;15(1):42-44.
[17]蒋敏,谭继善.舌下神经鞘瘤的CT和MRI表现及其病理基础(附4例报告)[J].实用医学影像杂志,2002;3(2):137-139.
[18]谭学书,刘平.舌下神经鞘瘤恶变一例[J].中华神经外科杂志,2003;19(6):420.
[19]汪恒望,韩萍,梁波,等.舌下神经鞘瘤一例[J].临床放射学杂志,2003;22(8):679.
[20]杨百春,周良辅,毛颖,等.舌下神经鞘瘤诊断和治疗[J].中华外科杂志,2004;42(22):1384-8.
[21]金中高,周林江,姚振威.舌下神经鞘瘤的临床和MRI诊断[J].中华神经外科杂志,2007;23(9):669-671.
[22]陈志,冯华,朱刚.哑铃型舌下神经鞘瘤1例[J].第三军医大学学报.2007;29(17):1715-1723.
[23]吴震,张俊廷,贾桂军.耳后经髁上入路切除颈静脉孔区及舌下神经孔区肿瘤32例[J].中华外科杂志,2004;42(3):173-175.
[24]贾桂军,王忠诚,张俊廷.舌下神经孔区神经鞘瘤的诊断与显微外科治疗[J].中华医学杂志,2001;81(20):1264-1265.
[25]Foer DB,Hermans R,Sciot R,et al.Imaging case study of the month hypoglossal schwannoma.Ann Otol Rhinol Laryngol,1995,104:490-492.
[26]Sato M,Kanai N,Fukushima Y,et al.Hypoglossal neurinoma extending intraand extracranially:case report.Surg Neurol,1996,45:172-175.
[27]Morelli RJ.Intracranial neurilemmoma of the hypoglossal nevre.Review Report[J].Neurology.1966Jul;16(7):709-13.
[28]Fujiwara M,Bitoh S,Hasegawa H,et al.A case of intracranial hypoglossal neurinoma(author'transl)[J].No Shinkei Geka.1981 Jul;9(8):953-8.
[29]Kuramitsu T,Seiki,Y Shibata I,et al.A case of intracranial hypoglossal neurinoma[J].No Shinkei Geka.1986 Nov;14(12):1463-9.
[30]Yamaguchi F, Takahashi H, Okada T, et al.A case of intracranial hypoglossal neurinoma with no preoperative hypoglossal nevre palsy[J].No Shinkei Geka.1990; 18(10):963-7.
[3 l] Takahashi, Tominaga T, Sato Y et al.Hypoglossal neurinoma presenting with intratumoral hemorrhage[J].J Clin Neurosci.2002 Nov; 9(6):716-9.
[32]Krauss JK, Bertalanffy H, Schwechheimer K, et al Ventral brain stem Schv/annoma at the entry zone of the hypoglossal nevre.Neurochirurgia(Stuttg)[J]. 1993 Mar; 36(2):66-9.
[33]Kobayashi S, Otsuka A, Tsunoda T, et al.Intracranial hypoglossal neurinoma without preoperative hypoglossal nevre paresis-case report[J]Neuro133 Med Chir(Tokyo).1996 Jun; 36(6):384-7.
[34]Sarma S, Sekhar LN, Schessel DA.Nonvestibular schwannomas of the brain: a 7-year experience[J].Neurosurgery, 2002; 50(3):437-449.
[35]Gilsbach JM, Sure U, Mann W.The supracondylar approach to the jugular tubercle and hypoglossal canal[J].Surg Neurol 1998:50:563-70.
[36]Passacantilli E, Lanzino G, Henn JS, et al.Intracranial extradural schwannoma of the 12 th cranial nevre.Case illustration[J].J Neurosurg.2003; 98(1):219.
[37]McCurdy JA Jr, Hays LL, Johnson GK.Parapharyngeal neurilemmoma of the hyoglossal nevre[J], Laryngoscope. 1976 May; 86(5):724-7.
[38]FleuryP, Laccourreye H, Basset JM, et al.An impressively lagre trilobulate neuroma of the XIIth cranial nerve (author's transl)[J].Ann Otolaryngol Chir Cervicofac.1979 Sep-Oct; 96(10-11):781-8.
[39]Sutay S , Tekinsoy B , Ceryan K , et al.Submaxillary hypoglossaJ neurilemmoma[J].J Laryngol Otol.1993 Oct; 107(10):953-4.
[40]De Foer B, Hermans R, Sciot R, et al.Hypoglossal schwannoma[J].Ann Otol Rhinol Laryngol. 1995 Jun; 104(6):490-2.
[41]Ogawa T, Kitagawa Y, ogasawara T.A multifocal neurinoma of the hypoglossal nerve with motor paralysis confirmed by electromyography[J].Int J Oral Maxillofac Surg.2001 Apr; 30(2): 176-8.
[42]Chang KC , Leu YS.Hypoglossal schwannoma in the submandibular space[J].The Journal of Laryngology and Otology, 2002:116(1):63.
[43]Myatt HM, Holland NJ, Cheesman AD.A skul 1 base exrtadural hypoglossal neurilemmoma resected via an extended posterolateral apporach[J].J Laryngol Otol. 1998 Nov; 112(11): 1052-7.
[1]Karasu A,Cansever T,Batay F,et al.The microsurgical anatomy of the hypoglossal canal[J].Surg Radiol Anat.2009 Jan 14.[Epub ahead of print].
[2]Lang J.Skull base and related structures.见孙为群,滕良珠主译.颅底与相关结构临床解剖图谱[M].山东,山东科学技术出版社:274-312,2002.
[3]丁白海,于春江,田德润,等.颅颈结合区的显微外科解剖[J].中华外科杂志,2002;40:427-430
[4]Rhoton AL.The foramen magnum[J].Neurosurgery 2000;47:5155-193.
[5]Naguib M,Aristegui M,Cokkeser Y,et al.Lower skullbase:anatomical study with surgical implications[J].Ann Otol Rhinol Laryngol 1995,104:57-61.
[6]Wysocki J,Kobryn H,Bubrowski M,et al.The morphology of the hypoglossal canal and its size in relation to skull capacity in man and other mammal species[J].Folia Morphol(Warsz).2004;63(1):11-7.
[7]VoVyodic F,Whyte A,Slavotinek J.The hypoglossal canal:normal MR Enhancement pattern[J].1995,AJNR 16:1707-1710.
[8]Day JD,Kellogg JX,Tschabitscher M,et al.Surface and superficial surgical anatomy of the posterolateral craniall base:significance for surgical planning and approach[J].Neurosurgery,1996;38(6):1079-1083.
[9]Avci E,Kocaogullar Y,Fossett D,et al.Lateral posterior fossa venous sinus relationships to surface lanmarks[J].Surg Neurol.2003;59(5):392-397.
[10]Uz A,Ugur HC,Tekdemir I.Is the asterion a reliable landmark for the lateral approach to posterior fossa?[J].J Clin Neurosci.2001;8(2):146-147.
[11]Gusmao S,Reis C,Tazinaffo U,et al.Definition of the anterolateral occipital lobe limit in anatomical specimens and image examination[J].Arq Neuropsiquiatr.2002;60(1):41-46.
[12]Ucerler H,Govsa F.Asterion as a surgical landmark for lateral cranial base approaches[J].J Craniomaxillofac Surg.2006 Oct;34(7):415-20.Epub 2006 Sep 11.
[13]杨百春,周良辅,毛颖,等.舌下神经鞘瘤诊断和治疗[J].中华外科杂志,2004;42(22):1384-8.
[14]高士镰,吕永利,张力伟.实用脑血管图谱[M].北京,科学技术出版社,2002:79-88.
[15]Wen HT,Rhoton AL,Katsuta T,et al.Microsurgical anatomy of the transcondylar,supracondylar,and paracondylar extensions of the far-lateral approach[J].J Neurosurg,1997;87:555-585.
[16]Spektor S,Anderson GJ,Memenomey SO,et al.Quantitative description of the far-lateral transcondylar transtubercular approach to the foramen and cliuvs[J].J Nuerosrug 92:824-831,2000.
[17]J Neurosurg.2006 Nov;105(5):753-7.Jugular tubercle:Morphometric analysis and surgical significance.Mintelis A,Sameshima T,Bulsara KR,Gray L,Friedman AH,Fukushima T.
[18]Samii M,Babu RP,Tatagiba M,et al.Surgical treatment of jugular foramen schwannomas[J1.JNeurosurg1995;82(6):924-32.
[19]Market JM,Chanddler WF,Deveikis JP,et al.Use of the exrteme lateral approach in the sugrical treatment of an intradural ventral cevrical spinal cord vascular malformation technical case report[J].Neurosurgery,1996,38:412-415.
[20]贾桂军,王忠诚,张俊廷.舌下神经孔区神经鞘瘤的诊断与显微外科治疗[J].中华医学杂志,2001;81(20):1264-1265.
[21]Sarma S,Sekhar LN,Schessel DA.Nonvestibular schwannomas of the brain:a 7-year experience[J].Neurosurgery,2002;50(3):437-449.
[22]吴震,张俊廷,贾桂军.耳后经髁上入路切除颈静脉孔区及舌下神经孔区肿瘤32例[J].中华外科杂志,2004;42(3):173-175.
[1]杨百春,周良辅,毛颖,等.舌下神经鞘瘤诊断与治疗[]J.中华外科杂志,2004;42(22):1384-8.
[2]Morelli RJ.Intracranial neurilemmoma of the hypoglossal nevre.Review and case report[J].Neuorlogy.1966Jul;16(7):709-13.
[3]Fujiwara M,Bitoh S,Hasegawa H,et al.A case of intracranial hypoglossal neurinoma(author's,transl)[J].No Shinkei Geka.1981 Jul;9(8):953-8.
[4]Kuramitsu T,Seiki Y,Shibata I,et al.A case of intracranial hypoglossal neurinonal[J].No Shinkei Geka.1986 Nov:14(12):1463-9.
[5]Yamaguchi F,Takahashi H,Okada T,et al.A case of intracranial hypoglossal neurinoma with no peroperative hypoglossal nevre palsy[J].No Shinkei Geka.1990Oct;18(10):963-7.
[6]Samra S,Sekhar LN,Schessel DA.Nonvestibular schwannomas of the brain:a year experience[J].Neurosurger y,2002;50(3):437-49.
[7]Passacantilli E,Lanzino G,Henn JS,et al.Intracranial extradural schwannoma of the 12th cranial nevre.Case illustration[J].J Neurosurg.2003 98(1):219..
[8]Gabriel Calzada,M.D.,Brandon Isaacson,M.D.,Daniel Yoshor,M.D.,et al.Surgical Approaches to the Hypoglossal Canal[J].Skull Base.2007 May;17(3):187-196.
[9]刘庆良,王忠诚,于春江,等.颈静脉孔区显微解剖[J].中华神经外科杂志,2004,20(1):10-13.
[10]朱权,袁贤瑞,刘庆,等.应用枕下经颈静脉突入路显微手术切除颈静脉孔 区肿瘤[J].中华神经外科杂志 2006,22(7):391-395.
[11]吴波,游潮,蔡博文,等.远外侧入路治疗颅颈交界腹侧病变的探讨[J].中华外科杂志,2005,43(9):612-615.
[12]Kawashima M,Tanriover N,Rhoton AL et al Comparison of the far lateral and extreme lateral variants of the atlanto-occipital transarticular approach to anterior extradural lesions of the craniovertebral junction[J].Neurosurgery,2003;53(3):662-675.
[13]张俊廷,王忠诚,昊震,等.枕骨大孔区脑膜瘤显微外科手术治疗[J].中华神经外科杂志2000,16(3):159-161.
[1]Boulton MR,Cusimano MD.Foramen magnum meningiomas:concepts,classifications,and nuances[J].Neurosurg Focus.2003 Jun 15;14(6):e10.
[2]冯东侠,叶富华,徐卫东,等.枕髁形态学分类对下斜坡病变的手术意义[J].中华神经外科杂志,2007,23(4)253-256.
[3]武志强,张绍祥,王斌全,等.基于数字化人体的颞骨可视化模型初步研究[J].实用医技杂志,2008,15(17):2188-2190.
[4]Salas E,Sekhar LN,Ziyal IM,et al.Variations of the extreme-lateral craniocervical approach:anatomical study and clinical analysis of 69 patients[J].J Neurosurg.1999 Apr;90(2 Suppl):206-19.
[5]Bejjani GK,Sekhar LN,Riedel CJ.Occipitocervical fusion following the extreme lateral transcondylar approach[J].Surg Neurol.2000 Aug;54(2):109-15;discussion 115-6.
[6]Vishteh AG,Crawford NR,Melton MS,Stability of the craniovertebral junction after unilateral occipital condyle resection:a biomechanical study[J].J Neurosurg.1999 Jan;90(1 Suppl):91-8.
[1]Arnold H.Menezes MD.Transoral Approaches to the Craniocervical Junction[J].Operative Techniques in Neurosurgery,2005;8(3):116-124.
[2]Katsuta T,Rhoton AL Jr,Matsushimu T.The jugular foramen:microsurgical anatomy and operative approaches[J].Neurosurgery,1997;41(1):194-202.
[3]Ozveren MF,Ture U,Ozek MM,et al.Anatomic landmarks of the glossopharyngeal nerve:a microsurgical anatomic study.Neurosurgery,2003;52(6)1400-1410.
[4]Duvernor HM.Human brain stem vessals(2nd edition):Springe Verlag:Berlin,Heidelberg,1999:28-32.
[5]张力伟,王忠诚,于春江.延髓腹外侧动脉显微外科研究.中华神经外科杂志,2001;17(6)357-360.
[6]Mitsuhashi Y,Nishio A,Kawahara S,et al.Morphologic evaluation of the caudal end of the inferior petrosal sinus using 3D rotational venography[J].AJNR Am J Neuroradiol.2007 Jun-Jul;28(6):1179-84
[7]Rhoton AL Jr.The Cerebellopontine Angle and Posterior fossa cranial nerves by the retrosigmoid approach[J].Neurosurgery(Supplement),2000;47(3):93-129.
[8]Krishnamurthy A,Nayak SR,Khan S,et al.Arcuate foramen of atlas:incidence,phylogenetic and clinical significance[J].Rom J Morphol Embryol.2007;48(3):263-266.
[9]种衍军.舌咽神经痛的手术治疗与病因学探讨[J].中华神经外科杂志, 1999;15(2):94-96.
[10]Ryan S,Blyth P,Duggan N,,et al.Is the cranial accessory nerve really a portion of the accessory nerve? Anatomy of the cranial nerves in the jugular foramen[J].Anat Sci Int.2007 Mar;82(1):1-7.
[11]葛明,张俊廷,吴震,等.远外侧入路切除颅颈区肿瘤[J].中华显微外科杂志,2001;24:230-231.
[12]Wen HT,Rhoton AL Jr,Katsuta T,et al.Microsurgical anatomy of the transcondylar,supracondylar,and paracondylar extensions of the far-lateral approach[J].J Neurosurg,19971;87:555-585.
[13]Bruneau M,George B.Foramen magnum meningiomas:detailed surgical approaches and technical aspects at Lariboisiere Hospital and review of the literature[J].Neurosurg Rev.2007;31(1):19-33.
[14]陈刚,陈坚,王仲伟,等.枕骨大孔区脑膜瘤的外科治疗[J].中国耳鼻咽喉颅底外科杂志,2001,7(4):212.
[15]漆松涛.显微神经外科手术图解及述评[M].人民卫生出版社,2003.6:37.
[1]Fisch,U.;Infratemporal fossa approach for glomus tumors of the temporal bone.Ann Otol Rhinol Laryngol.1982;91:474-479.
[2]Oghalai, J S; Leung, M K Jackler, R K; McDermott, M W.; Transjugular craniotomy for the management of jugular foramen tumors with intracranial extension. Otol Neurotol. 2004; 25:570-579. [3]Smith, P G; Backer, R J Kletzker, GR; et al. Surgical management of transcranial hypoglossal schwannomas. Am J Otol. 1995; 16:451-456.
[4]Wen, HT; Rhoton, A L, Jr Katsuta, T; de Oliveira, E.; Microsurgical anatomy of the transcondylar, supracondylar, and paracondylar extensions of the far-lateral approach. J Neurosurg. 1997; 87:555-585.
[5]Oghalai, J S; Leung, M K Jackler, R K; McDermott, M W.; Transjugular craniotomy for the management of jugular foramen tumors with intracranial extension. Otol Neurotol. 2004; 25:570-579.
[6]Sekhar, L N Estonillo, R.; Transtemporal approach to the skull base: an anatomical study. Neurosurgery. 1986; 19:799-808.
[7]Rhoton AL.The foramen magnum[J].Neuorsurg 2000; 47:S 155-193.
[8]Naguib M, Aristegui M, Cokkeser Y, et al.Lower skullbase: anatomical study with surgical implications[J].Ann Otol Rhinol Laryngol 1995 , 104:57-61.
[9]Wysocki J, Kobryn H, Bubrowski M, et al.The morphology of the hypoglossal canal and its size in relation to skull capacity in man and other mammal species[J].Folia Morphol(Warsz).2004; 63(1):11-7.
[10]By GEOFFREY A.WARDWELL,M.D.,JOHN A.GOREE,M.D., JOHN P.JIMENEZ,M.D..THE HYPOGLOSSAL ARTERY AND HYPOGLOSSAL AND HYPOGLOSSAL CANAL[J]. Am. J. Roentgenol, Jul 1973; 118: 528-533.
[11]Elhammady MS, Ba(?)kaya MK, Sonmez OF,et al. Persistent primitive hypoglossal artery with retrograde flow from the vertebrobasilar system: a case report[J]. Neurosurg Rev. 2007 Oct; 30(4):345-9; discussion 349. Epub 2007 Aug 9.
[12]VoVyodic F, Whyte A, Slavotinek J.The hypoglossal canal:normal MR Enhancement pattern[J].AJNR 16:1707-1710, 1995.
[13]Baldauf J, Junghans D, Schroeder HW. Endoscope-assisted microsurgical resection of an intraneural ganglion cyst of the hypoglossal nerve[J]. J Neurosurg. 2006 Jun; 104(6):990-2; author reply 992.
[14]Chennupati SK, Norris R, Dunham B,et al. Osteosarcoma of the skull base: case report and review of literature[J]. Int J Pediatr Otorhinolaryngol. 2008 Jan; 72(1):115-9. Epub 2007 Nov 5.
[15]De Martel T, Subirana A, Guillaume J.Los tumores de le fosa cerebral posterior voluminoso neurinoma del hipogloso con desarrollo juxtabullbo-protuberan[j]Operacioncuracion Ars Med 1933; 9:416-9.
[16]Rachinger J, et al.Dumbbell-shaped hypoglossal schwannoma.A case report[J].Mangetic Resonance Imgaing 21(2003)155-158
[17]Bekta(?) D, Caylan R. Bilateral hypoglossal schwannoma: a radiologic diagnosis[J]. Kulak Burun Bogaz Ihtis Derg. 2004; 12(1-2):45-7.
[18]Mori K, Nakao Y, Yamamoto T, et al. Intradural jugular tuberclectomy in a case of inadequate extradural removal. Surg Neurol. 2005 Oct ; 64(4):347-50; discussion 350.
[19]Tatagiba M, Koerbel A, Roser F. The midline suboccipital subtonsillar approach to the hypoglossal canal: surgical anatomy and clinical application[J]. Acta Neurochir (Wien). 2006 Sep; 148(9):965-9. Epub 2006 Jul 5.
[20]Kikkawa Y, Shono T, Mizoguchi M,et al. A case of intracranial hypoglossal neurinoma without hypoglossal nerve palsy: operative view of the preserved rostral trunk[J]. Minim Invasive Neurosurg. 2007 Oct; 50(5):296-9.
[21]Tucker A, Miyake H, Tsuji M,et al. Intradural microsurgery and extradural gamma knife surgery for hypoglossal schwannoma: case report and review of the literature[J]. Minim Invasive Neurosurg. 2007 Dec; 50(6):374-8.
[22]Gabriel Calzada, M.D.,1 Brandon Isaacson, M.D.,1 Daniel Yoshor, M.D.,2 et al. Surgical Approaches to the Hypoglossal Canal[J]. Skull Base. 2007 May; 17(3): 187-196.
[23]Kuo LT, Huang AP, Kuo KT, et al. Extradural dumbbell schwannoma of the hypoglossal nerve: a case report with review of the literature[J]. Surg Neurol. 2008 Dec; 70 Suppl 1 :S 1:34-8; discussion S1:38-9. Epub 2008 Apr 18.
[24] 杨江帆.舌下神经鞘瘤1例[J].中国肿瘤临床 ,1994；2：156.
[25]梁勇,周良辅,毛颖,等.舌下神经鞘瘤的诊断和治疗[J].中国神经精神疾病杂志,1997;23(6):321-3.
[26]舌下神经鞘瘤[J].中华神经外科杂志,1999;15(1):42-44.
[27]蒋敏,谭继善.舌下神经鞘瘤的CT和MRI表现及其病理基础(附4例报告)[J].实用医学影像杂志,2002;3(2):137-139.
[28]谭学书,刘平.舌下神经鞘瘤恶变一例[J].中华神经外科杂志,2003;19(6):420.
[29]汪恒望,韩萍,梁波,等.舌下神经鞘瘤一例[J].临床放射学杂志,2003;22(8):679.
[30]杨百春,周良辅,毛颖,等.舌下神经鞘瘤诊断和治疗[J].中华外科杂志,2004;42(22):1384-8.
[31]金中高,周林江,姚振威.舌下神经鞘瘤的临床和MRI诊断[J].中华神经外科杂志,2007;23(9):669-671.
[32]陈志,冯华,朱刚.哑铃型舌下神经鞘瘤1例[J].第三军医大学学报.2007;29(17):1715-1723.
[33]吴震,张俊廷,贾桂军.耳后经髁上人路切除颈静脉孔区及舌下神经孔区肿瘤32例[J].中华外科杂志,2004;42(3):173-175.
[34]贾桂军,王忠诚,张俊廷.舌下神经孔区神经鞘瘤的诊断与显微外科治疗[J].中华医学杂志,2001;81(20):1264-1265.
[35]Foer DB,Hermans R,Sciot R,et al.Imaging case study of the month hypoglossal schwannoma.Ann Otol Rhinol Laryngol,1995,104:490-492.
[36]Sato M,Kanai N,Fukushima Y,et al.Hypoglossal neurinoma extending intra-and extracranially: case report. Surg Neurol , 1996 , 45 : 172-175.
[37]Morelli RJ.Intracranial neurilemmoma of the hypoglossal nevre.Review Report [J].Neurology.l966Jul; 16(7):709-13.
[38]Fujiwara M, Bitoh S, Hasegawa H, et al.A case of intracranial hypoglossal neurinoma(author'transl)[J].No Shinkei Geka.1981 Jul ; 9(8):953-8.
[39]Kuramitsu T, Seiki, Y Shibata I, et al.A case of intracranial hypoglossal neurinoma[J].No Shinkei Geka.1986 Nov; 14(12): 1463-9.
[40]Yamaguchi F, Takahashi H, Okada T, et al.A case of intracranial hypoglossal neurinoma with no preoperative hypoglossal nevre palsy[J].No Shinkei Geka. 1990; 18(10):963-7.
[41]Takahashi, Tominaga T, Sato Y et al.Hypoglossal neurinoma presenting with intratumoral hemorrhage[J].J Clin Neurosci.2002 Nov; 9(6):716-9.
[42]Krauss JK, Bertalanffy H, Schwechheimer K, et al Ventral brain stem Schwannoma at the entry zone of the hypoglossal nevre.Neurochirurgia(Stuttg)[J].1993 Mar; 36(2):66-9.
[43]Kobayashi S, Otsuka A, Tsunoda T, et al.Intracranial hypoglossal neurinoma without preoperative hypoglossal nevre paresis-case report[J]Neuro 133 Med Chir(Tokyo).1996 Jun; 36(6):384-7.
[44]Sarma S, Sekhar LN, Schessel DA.Nonvestibular schwannomas of the brain: a 7-year experience[J].Neurosurgery, 2002; 50(3):437-449.
[45]Gilsbach JM, Sure U, Mann W.The supracondylar approach to the jugular tubercle and hypoglossal canal[J].Surg Neurol 1998:50:563-70.
[46]Passacantilli E, Lanzino G, Henn JS, et al.Intracranial extradural schwannoma of the 12 th cranial nevre.Case illustration[J].J Neurosurg.2003; 98(1):219.
[47]Kempe LG(1970).Operative neurosurgery[M], Vol 2.Springer, Berlin Heidelberg New York, pp34-35, 46-53, 72-79.
[48]Miller R(1979).Meningiomas of the posterior fossa[M].In:Buchheit WA(eds).Surgery of the posterior fossa.Raven, New York, 99-100.
[49]Rhoton AL Jr, de oliveira E.Suboccipital and retrosigmoid approaches to the craniovertebral junction, in Dickman CA, Spetzler RF, Sonntag VKH(eds):Surgery of the Craniovertebral Junction[M].New York, Thieme Medical Publishers, Inc, 1998, pp659-681.
[50]Sen CN, Sekhar LN.Surgical management of anteriorly placed lesions at the craniocervical junction-an alternative approach[J].Acta Neurochir(Wien)1991; 108:70-77.
[51]Seeger W, Atlas of Topographical structures.Wein:Spinger.Verlag[J], 1978, Anatomy of the Brain and Surrounding 25:486-4892.
[52]Heros RC.Lateral suboccipital approach for vertebra and veterbrobasilar artery lesions[J].JNeurosurgery, 1986, 20:207-214.
[53]Spetzler RF.Grahm TW.The far lateral approach to the inferior clivus and the upper cervical region.technical note[J].Barrow Neuroliyical Institute Quarterly 1990, 6:35-38.
[54]Bertanlanffy H, Seeger W, The dorsolateral, suboccipital.transcondylar approach to the lower clivus and anterior portion of the craniocervical junction[J], Neurosurg, 1991, 29:815-821.
[55]Sekhar LN, Jannetta PJ, Bukrhart LE, et al.Meningioma involving the clivus a years experience with 41 patients[J].Neurosurgery, 1990, 27:764-781.
[56]Schilling V, Grevers G, Miller A.Eine Moddification des transcondylar Zugang Zum Foramen jugulare Klin[J].Moatsbl.Augenheikd, 1996, 41:209-223.
[57]Seyffed Dmand Rock JP.The transcondylar approach to the Juglar Foramen:A comparative Anatomic study[J].Surg Neuorl, 1994, 42:265-71.
[58]Market JM, Chanddler WF, Deveikis JP,et al.Use of the exrteme lateral approach in the sugrical treatment of an intradural ventral cevrical spinal cord vascular malformation technical case report[J]. Neurosurgery, 1996, 38:412-415.
[59]John E, Wanebo.M.D.Quantitive Analysis of the Transcondylar approch to the Foramen Magnum[J].Neurosurgery, 2001, 49:934-955.
[60]Nanda A, Vincent DA, Vannemreddy PSSV, et al.Far-lateral approch to Intradural lesions of the foramen magnum without resection of the occipital condyle[J].J Neurosurg 2002; 96:302-09
[61]Wanebo,JE, Chicoine MR.Quantitative analysis of the transcondylar approch to the foramen magnum[J]. Neurosurg 2001; 49:934-943.
[62]Spektor S, Anderson GJ, Memenomey SO, et al.Quantitative description of the far-lateral transcondylar transtubercular approach to the foramen and cliuvs[J] .J Nuerosrug 92:824-831, 2000.
[63]Wen HT, Rhoton AL, Katsuta T, et al.Microsurgical anatomy of the transcondylar, supracondylar, and paracondylar extensions of the far-lateral approach[J].J Neurosurg, 1997; 87:555-585.
[64]Salas E, Sekhar LN, Ziyal IM, et al.Variations of the extreme-lateral craniocervical approach:anatomical study and clinical analysis of 69 patients[J]. JNeurosurg, (Spine 2)90:206-219, 1999.
[65]Vishtch AG, Crawford NR, Melton MS , et al.Stablitiy of the craniovertibral junction after unilateral occipitial condyle resection:a biomechanical study[J].Spine, 1999; 90(1):91-8.
[66]Babu RP, Sekhar LN, Wright DC.Extreme lateral transcondylar approach: Technical improvements and lessons leamed[J].JNeurosurg 1994, 81:49-59.
[67]Sen CN, Sekhar LN.An extreme lateral apporach to intradural lesions of the cervical spine and foramen magnum[J].Neurosurgery 1990; 27:197-204.
[68]George B, Dematons C, Cophignon J.Lateral approach to the anterior portion of the foramen magnum Application to surgical removal of 14 benign tumors:technical note[J].Surg Neurol 1988, 29:484-490.
[69]Matsushima T, Matsukado K, Natori Y, et al.Surgery on a saccular vertebral artery-posterior inferior cerebellar artery aneurysm via the transcondylar fossa (supracondylar transjugular tubercle)approach: surgical results and indications for using two different lateral skull base approaches[J]JNeurosurg, 2001; 95:268-274.
[70]Fisch, U Pillsbury, H C; Infratemporal fossa approach to lesions in the temporal bone and base of the skull. Arch Otolaryngol. 1979; 105:99-107.
[71]Glassock, M E, III; Jackson, C G Dickins, J R; Wiet, R J.; Panel discussion: glomus jugulare tumors of the temporal bone-the surgical management of glomus tumors. Laryngoscope. 1979; 89:1640-1654.
[72]Hadley, K S Shelton, C. ; Infratemporal fossa approach to the hypoglossal canal: practical landmarks for elusive anatomy. Laryngoscope. 2004; 114:1648-1651.
[73] Fisch, U.; Infratemporal fossa approach for glomus tumors of the temporal bone. Ann Otol Rhinol Laryngol. 1982; 91:474-479.
[74]Franklin, D J; Moore, G F; Fisch, U.; Jugular foramen peripheral nerve sheath tumors. Laryngoscope. 1989; 99:1081-1087.
[75]Sekhar LN , Schramm VL , Jones NF.Subtemporal-preauricular infratemporal fossa approach to large lateral and posteriorcranial base neoplasms[J].J Neurosurg, 1987; 67: 488-499.
[76]Sen CN, Sehhar LN.The subtemporal and preauricular infratemporal approach to intradural structures ventral to the brain stem[J].J Neurosurg, 1990; 73: 345-354.
[77]McCurdy JA Jr, Hays LL, Johnson GK.Parapharyngeal neurilemmoma of the hyoglossal nevre[J], Laryngoscope. 1976 May; 86(5):724-7.
[78]Fleury P, Laccourreye H, Basset JM, et al.An impressively lagre trilobulate neuroma of the XIIth cranial nerve (author's transl)[J].Ann Otolaryngol Chir Cervicofac.1979 Sep-Oct; 96(10-11):781-8.
[79]Sutay S, Tekinsoy B, Ceryan K, et al.Submaxillary hypoglossal neurilemmoma[J].J Laryngol Otol.1993 Oct; 107(10):953-4.
[80]De Foer B, Hermans R, Sciot R, et al.Hypoglossal schwannoma[J].Ann Otol Rhinol Laryngol. 1995 Jun; 104(6):490-2.
[81]Ogawa T, Kitagawa Y, ogasawara T.A multifocal neurinoma of the hypoglossal nerve with motor paralysis confirmed by electromyography[J].Int J Oral Maxillofac Surg.2001 Apr; 30(2): 176-8.
[82]Chang KC, Leu YS.Hypoglossal schwannoma in the submandibular space[J].The Journal of Laryngology and Otology, 2002:116(1).63.
[83]Myatt HM, Holland NJ, Cheesman AD.A skul 1 base exrtadural hypoglossal neurilemmoma resected via an extended posterolateral apporach[J].J Laryngol Otol.1998 Nov; 112(11):1052-7.
[84]Bordi TL, Cheesman AD, Symon L.The surgical management of glomus jugulare tumors-description of a single-staged posterolateral combined otoneurosurgical approach[J].Br J Neurosurg, 1989; 3(1):21 -30.
[85]Samii M, Babu RP, Tatagiba M, et al.Surgical management of jugular foramen schwannomas[J]J Neurosurg 1995:82(6):924-32.
[86]Serizawa T, Yamaura A, Osato K, et al.A case of intracranial hypoglossal neurinoma [J].No Shinkei Geka.1989 Mar; 17(3):279-83.
[87]Kachhara R, Nair S, Radhakrishnan VV.Large dumbbell neurinoma of Hypoglossal nevre:case report[J].Br J Neuorsurg. 1999 Jun; 13(3):338-40.
[88]Hoshi M, Yoshida K, Ogawa K, et al.Hypoglossal neurinoma case reports[J].Neurol Med Chir(Tokyo).2000 Sep; 40(9):489-93.
[89]Rachinger J, Fellner AF, Trenkler J.Dumbbell-shaped hypoglossal schwannoma.A case report[J].Mangnetic Resonnace Imgaing 21 (2003) 155-158.
[90]Odake G. Intracranial hypoglossal neurinoma with exrtacranial extension:review and case report[J].Neurosurgery, 24(4):583-587, 1989.
[91]Kamitani H , Masuzawa H , Kanazawa I , et al.A combined exrtadural-posterior petrous and suboccipital approach to the jugular foramen tumors[J].Acta Neurochir(Wien). 1994; 126(2-4): 179-84.
[92]Fujita K, Nozkai K, Nagata I, et al.A case of dumbbell-shaped hypoglossal neurinoma[J].No Shinkei Geka. 1994 Aug; 22(8):775-9.
[93]Smith PG,Backer RJ, Kletzker GR, et al.Surgical management of transcranial hypoglossal schwannomas[J].Am J Otol. 1995 Jul; 16(4):451 -6.
[94]Sato M, Kanai N, Fukushima, et al. Hypoglossal neurinoma extending intra-and extracraniallyxase report[J].Surg Neurol 1996; 45:172-5.
[95]Spinnato S , Talacchi A , Musumeci A , et al.Dumbbell-Shaped Neurinoma:Surgical Removal via a dorsolateral transcondylar approch.A Case Report and Review of the Literature[J].Acta Neuorchir(Wien) (1998) 140: 827-832.
[96]Canalis RF, Martin N, Black Keith, et al.Lateral approach to tumors of the craniovertebral junction[J].Laryngoscope 103:343-47, 1993.
[97]Bunc VG, Milojkovic G, Kosceir S, et al.Dumb-bell hypoglossal neurinoma.With Intra-and Extracranial Paravertebral Expansion[J].Acta Neurochir(Wien)(1998) 140:1209-1210.
[98]Hakuba A, Hashi K, Fujitani K, et al.Jugular foramen neurinomas[J].Surg Neurol 1979; 11:83-94.